After effects of shingles11/19/2023 ![]() Shingles treatment aims to limit symptom severity and pain duration, decrease viral shedding, and prevent PHN. Herpes zoster usually lasts between seven and 10 days however, the skin lesions may take up to one month to heal.Ī shingles diagnosis often is made clinically but can be confirmed by immunofluorescent staining of cells from the lesion base, isolation of VZV in tissue culture, or by detection of VZV DNA by polymerase chain reaction.8 A PHN diagnosis is made when pain lasts for three months or longer after an acute attack of shingles or appears after the skin lesions have healed. The pain often is described as having two components: an ongoing burning or raw, severe aching and superimposed paroxysmal pains of stabbing or electric quality.7 Preeruptive pain (prodrome) before the development of the typical rash may be present for 48 to 72 hours. ![]() A painful vesicular rash in a unilateral dermatomal distribution, often involving the T3-元 dermatomes or the ophthalmic division of the trigeminal nerve, usually follows the initial symptoms. The earliest symptoms of shingles are nonspecific and include headache, fever, and malaise. Other risk factors include being female and reduced immune function for various reasons, such as HIV infection, cancer, prolonged steroid therapy, chemotherapy, and psychological stress.3Īlthough difficult to estimate, PHN occurs in 10% to 20% of shingles patients.4 Individuals over the age of 60 are at increased risk of developing PHN and suffering a prolonged course.5 Risk factors are thought to include more severe acute pain, the presence of a prodrome (preeruptive pain), and a more severe rash.6 The incidence of shingles in healthy individuals is about 0.2% in patients under the age of 50 and increases to 1% in those over the age of 80.2 The increase in herpes zoster in the elderly is thought to be a consequence of decreasing cellular immune function. Other rare complications may occur, including aseptic meningitis, facial paralysis, and encephalitis. The most common complication is the development of postherpetic neuralgia (PHN), which is nerve pain lasting for more than three months after the acute rash has healed.1 PHN can be debilitating and last for years. Shingles usually lasts from two to three weeks, and early treatment with antiviral agents can reduce complications. It typically presents with pain, a rash, and blistering in a dermatomal distribution. Reactivation of VZV often happens in individuals over the age of 60 or when the immune system is weakened by medications or disease. Instead, the virus stays in the nerve cell bodies and less frequently in the non-neuronal satellite cells of the dorsal root ganglia, cranial nerve, or autonomic ganglia, where it remains in a dormant state until it becomes reactivated later in life. VZV often is contracted early in life and causes chicken pox, but it is not fully cleared by the immune system. Shingles is a painful skin condition caused by the reactivation of a dormant varicella zoster virus (VZV). With an estimated 1 million cases each year, nearly one in three Americans will develop shingles, and between 1% and 4% of people suffering from shingles are hospitalized for complications, the CDC notes. ![]() The incidence of shingles (herpes zoster) in the United States among people aged 60 and older is about 10 per 1,000 people, according to the Centers for Disease Control and Prevention (CDC). ![]() ![]() By Shengping Zou, MD, and Steven Ropers, MD ![]()
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