Herpes Zoster Virus Infection (Shingles)
By: Bernadette Lou Caluya, MD, DPDS
What is Shingles?
What Causes Shingles?
Who Gets Shingles?
Anyone can get Shingles but the following groups of people have an increased risk of acquiring the disease:
- immunocompromised individuals (organ transplant patients, cancer patients)
- patients with immune-mediated conditions (systemic lupus erythematosus, rheumatoid arthritis etc.)
- patients undergoing chemotherapy, immunomodulators and corticosteroids
- HIV patients
What are the physical findings?
What are the other signs and symptoms?
- Pain – described as burning, deep-aching, tingling, stabbing or lancinating. It can occur as early as 1 to 3 days prior to the appearance of the skin lesions
- Paresthesia – “pins and needles” on the affected areas
- Pruritus – can be apparent in the early stages of the disease until the crusts fall off
Is it infectious?
YES, Herpes Zoster Virus infection is infectious. A patient can transmit it to other people through direct contact with the vesicles until 7 days from the initial appearance of the skin lesions. It can also be airborne in some cases. The people who have exposure with patients with Shingles won’t develop Shingles, they will develop chickenpox.
It is important for patients to avoid exposure to pregnant mothers, elderly people, newborns and children.
Is it treatable?
YES, HZV infection is treatable.
- ORAL ANTI-VIRAL MEDICATIONS
- It is important to seek consult with a dermatologist once the skin lesions are noted. Anti-viral medications are effective if given during the first 72 hours of the disease. It is proven that anti-viral therapy can decrease the duration and severity of the skin rash and associated pain. It also prevents the appearance of lesions to other parts of the body.
- TOPICAL TREATMENT OPTIONS
can be beneficial during the acute phase to relieve pruritus and pain. It can also hasten the drying of skin lesions
- Cool compress
- Calamine lotion
- TOPICAL CORTICOSTEROIDS should not be used
- anti-viral ointments or creams are not beneficial
What are the possible complications?
- Post –herpetic Neuralgia (PNH) – described as pain noted 1 to 6 months after the healing of the rash. Incidence and duration increases with age.
- Bacterial superinfection
- Pneumonitis, Hepatitis, Esophagitis
- Eye complications