Shingles

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What is it?

Shingles medical name is herpes zoster. It is a viral disease. WebMD says that shingles is a skin rash that is quite painful and targets aged adults and individuals with immune systems that have been weakened – due to injury, stress, certain medications, etc.

Causes

Shingles are caused by the varicella zoster virus. When an individual is infected with this virus they will first get chicken pox.

This generally occurs in children, but can also occur during adulthood. After the chicken pox runs its course, the varicella zoster virus lays dormant. It can be years until it reappears in the nerve cell bodies and causes shingles. It can also appear in the cranial nerve, dorsal root, autonomic ganglion and other non-neuronal satellite cells.

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Symptoms

WebMD states that shingles happens in stages. Early symptoms of shingles are usually misdiagnosed, as they are quite common symptoms found in other diseases. They include fever, headache and malaise. Pins and needles, itching, oversensitivity and burning pain can follow these symptoms. Generally, the older the individual the more likely these will present themselves. It will also be quite severe. The level of pain can be really high.

After these early symptoms a rash will appear. It can be only 2 or 3 days after the first symptoms have presented themselves, or it can take a few weeks. The rash (and the pain) usually presents itself on the torso but it will also show up on other parts of the body. It is unique in that it will appear in a dermatonal pattern. It usually appears in strips.

Next, small blisters will appear in the rash. Eventually these blisters are filled up with blood and turn cloudy or dark in color. They then will crust over. Eventually the crust falls off. It can leave quite a bit of scarring.

Diagnosis

A Tsanck smear can be used to determine if the virus is present. However, the Tsanck smear does not differentiate between the zoster virus and common herpes. Generally, the rash will indicate that it is shingles, as its pattern is unique only to this virus. Without the rash it can be hard to diagnose. The rash might not be present because the individual has come to be diagnosed early on in the virus’ run or later, when the rash has already come and gone.
Blood tests are a good way of diagnosing shingles. Lymph from the blisters can also be taken and examined for the virus. Samples of lesions can also be tested with viral culture and real-time PCR in order to determine if the virus is present.

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Treatment

Steroids, antivirals, and analgesics are all used as treatments for shingles. These are used to help lower the risk of complications caused by the shingles, as well as to help lower the duration and severity.

Steroids are generally used only with older people because of the complications it can cause. People over 50 run a bigger risk of getting postherpetic neuralgia, so prednisone will be used in order to help alleviate some of the pain. It has been argued that the prednisone does little in terms of pain relief.

Valaciclovir, acyclovir and famciclovir are popular antivirals used in the treatment of shingles. They help to lower the duration and severity of shingles by inhibiting replication of the virus. They do not help with the postherpetic neuralgia. Antivirals, like steroids, are usually only given to people over 50 years of age.

A fairly common, over-the-counter, analgesic that is used for shingles is calamine lotion. It is applied to the rash and blisters and may help by soothing the pain. Capsaicin, gabapentin, lidocaine and even morphine can be applied topically in order to help lessen the pain of the shingles.