Notes

Shingles

Shingles, also known as zoster or herpes zoster, is a viral disease characterized by a painful skin rash with blisters in a localized area.Typically the rash occurs in a single, wide stripe either on the left or right side of the body or face. Two to four days before the rash occurs there may be tingling or local pain in the area.Encyclopedia Entry for Shingles :Shingles (zoster) - varicella zoster virus (Herpesvirus)Encyclopedia Entry for Shingles :Shingles - aftercare. An outbreak of shingles usually follows the following course: Blisters and pimples appear on your skin and cause pain. A crust forms over the blisters and pimples. In 2 to 4 weeks, the blisters and pimples heal. They rarely come back. Pain from shingles lasts for 2 to 4 weeks. You may have tingling or a pins-and-needles feeling, itching, burning, and a deep pain. Your skin may be very painful when it is touched. You may have a fever. You may have short-term weakness of certain muscles. This is rarely lifelong. To treat shingles, your health care provider may prescribe: A medicine called an antiviral to fight the virus A medicine called a corticosteroid, such as prednisone Medicines to treat your pain You may have postherpetic neuralgia ( PHN ) pain. This is pain that lasts longer than a month after symptoms of shingles start.To relieve itching and discomfort, try: A cool, wet compresses on the affected skin Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion Zostrix, a cream that contains capsaicin (an extract of pepper) Antihistamines to reduce itching (taken by mouth or applied to the skin) Keep your skin clean. Throw away bandages you use to cover your skin sores. Throw away or wash in hot water clothing that has contact with your skin sores. Wash your sheets and towels in hot water. While your skin sores are still open and oozing, avoid all contact with anyone who has never had chickenpox, especially pregnant women.Rest in bed until your fever goes down. For pain, you can take a type of medicine called NSAIDs. You do not need a prescription for NSAIDs. Examples of NSAIDs are ibuprofen (such as Advil or Motrin) and naproxen (such as Aleve or Naprosyn). If you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or bleeding, talk with your provider before using these medicines. You may also take acetaminophen (such as Tylenol) for pain relief. If you have liver disease, talk with your provider before using it. You may be given a narcotic pain reliever. Take it only as directed. These medicines can: Make you sleepy and confused. When you are taking a narcotic, DO NOT drink alcohol or use heavy machinery. Make your skin feel itchy. Cause constipation (not being able to have a bowel movement easily). Try to drink more fluids, eat high-fiber foods, or use stool softeners. Make you feel sick to your stomach. Try taking the medicine with food.Call your provider if: You get a rash that looks or feels like shingles Your shingles pain is not well-managed Your pain symptoms do not go away after 3 to 4 weeks.Herpes zoster - treatment.Habif TP. Warts, herpes simplex, and other viral infections.Encyclopedia Entry for Shingles :Shingles. After you get chickenpox, the virus remains inactive (becomes dormant) in certain nerves in the body. Shingles occurs after the virus becomes active again in these nerves after many years. Many people had such a mild case of chickenpox that they do not realize they have had the infection. The reason the virus suddenly becomes active again is not clear. Often only one attack occurs. Shingles can develop in any age group. You are more likely to develop the condition if: You are older than age 60 You had chickenpox before age 1 Your immune system is weakened by medicines or disease If an adult or child has direct contact with the shingles rash and did not have chickenpox as a child or get the chickenpox vaccine , they can develop chickenpox, not shingles.The first symptom is usually pain, tingling, or burning that occurs on one side of the body. The pain and burning may be severe and are usually present before any rash appears. Shingles Red patches on the skin, followed by small blisters, form in most people: The blisters break, forming small sores that begin to dry and form crusts. The crusts fall off in 2 to 3 weeks. Scarring is rare. The rash usually involves a narrow area from the spine around to the front of the abdomen or chest. The rash may involve the face, eyes, mouth, and ears. Herpes zoster (shingles) on the neck and cheek Other symptoms may include: Fever and chills General ill feeling Headache Joint pain Swollen glands (lymph nodes) You may also have pain, muscle weakness, and a rash involving different parts of your face if shingles affects a nerve in your face. The symptoms may include: Difficulty moving some of the muscles in the face Drooping eyelid (ptosis) Hearing loss Loss of eye motion Taste problems Vision problems.Your health care provider can make the diagnosis by looking at your skin and asking about your medical history. Tests are rarely needed, but may include taking a skin sample to see if the skin is infected with the virus. Blood tests may show an increase in white blood cells and antibodies to the chickenpox virus. But the tests cannot confirm that the rash is due to shingles.Your provider may prescribe a medicine that fights the virus, called an antiviral drug. This drug helps reduce pain, prevent complications, and shorten the course of the disease. The medicines are most effective when started within 72 hours of when you first feel pain or burning. It is best to start taking them before the blisters appear. The medicines are usually given in pill form. Some people may need to receive the medicine through a vein (by IV). Strong anti-inflammatory medicines called corticosteroids, such as prednisone, may be used to reduce swelling and pain. These medicines do not work in all people. Other medicines may include: Antihistamines to reduce itching (taken by mouth or applied to the skin) Pain medicines Zostrix, a cream containing capsaicin (an extract of pepper) to reduce pain Follow your provider's instructions about how to care for yourself at home. Other measures may include: Caring for your skin by applying cool, wet compresses to reduce pain, and taking soothing baths Resting in bed until the fever goes down Stay away from people while your sores are oozing to avoid infecting those who have never had chickenpox -- especially pregnant women.Herpes zoster usually clears in 2 to 3 weeks and rarely returns. If the virus affects the nerves that control movement (the motor nerves), you may have temporary or permanent weakness or paralysis. Sometimes the pain in the area where the shingles occurred may last from months to years. This pain is called postherpetic neuralgia. It occurs when the nerves have been damaged after an outbreak of shingles. Pain ranges from mild to very severe. Postherpetic neuralgia is more likely to occur in people over age 60.Complications may include: Another attack of shingles Bacterial skin infections Blindness (if shingles occurs in the eye) Deafness Infection, including encephalitis of sepsis (blood infection) in people with a weakened immune system Ramsay Hunt syndrome if shingles affects the nerves of the face or ear.Call your provider if you have symptoms of shingles, particularly if you have a weakened immune system or if your symptoms persist or worsen. Shingles that affects the eye may lead to permanent blindness if you do not receive emergency medical care.Do not touch the rash and blisters on people with shingles or chickenpox if you have never had chickenpox or the chickenpox vaccine. A shingles vaccine is available. It is different than the chickenpox vaccine. Older adults who receive the herpes zoster vaccine are less likely to have complications from shingles. .Herpes zoster - shingles.Herpes zoster (shingles) on the back Herpes zoster (shingles) on the back Adult dermatome Adult dermatome Shingles Shingles Herpes zoster (shingles) - close-up of lesion Herpes zoster (shingles) - close-up of lesion Herpes zoster (shingles) on the neck and cheek Herpes zoster (shingles) on the neck and cheek Herpes zoster (shingles) on the hand Herpes zoster (shingles) on the hand Herpes zoster (shingles), disseminated Herpes zoster (shingles) disseminated.Habif TP. Warts, herpes simplex, and other viral infections.Encyclopedia Entry for Shingles :Shingles (Herpes zoster). Source of disease: Varicella zoster virus (VZV)