acute herpes zoster

Question 1

what is herpes zoster

Answer 1

Herpes zoster is commonly known as shingles. It is a viral disease caused by reactivation of varicella-zoster virus which remains dormant in the sensory ganglia of the cranial nerve or the dorsal root ganglia after a previous varicella infection.

Question 2

herpes Zoster etiology

Answer 2

It is believed that zoster occurs due to the failure of the immune defense system to control the latent replication of the virus. The incidence of herpes zoster is strongly correlated to the immune status

Upon reactivation, the virus replicates in neuronal cell bodies, and virions shed from the cells which are carried down the nerve to the area of skin innervated by that ganglion.

triggers include:
Emotional stress
Use of medications (immunosuppressants)
Acute or chronic illness
Exposure to the virus
Presence of a malignancy

Question 3

Signs and symptoms

Answer 3

Zoster characteristically presents with a prodrome of fever, malaise, and excruciating burning pain followed by the outbreak of vesicles that appear in one to three crops over three to five days.
Lesions are distributed unilaterally within a single dermatome.

there are 3 phases
Preeruptive stage: Abnormal skin sensations, pain, headaches, general malaise, and sensitivity to light occur before visible lesions.
Acute eruptive phase: Painful vesicles form, rupture, ulcerate, and crust over, accompanied by severe pain and high infectivity.
Chronic infection: Recurrent, disabling pain lasting over 4 weeks, accompanied by paresthesias, shock-like sensations, and altered sensation.

Question 4

how is herpes zoster treated

Answer 4

• Antiviral therapy hastens the resolution of lesions, decreases acute pain and helps to prevent post-herpetic neuralgia especially in elderly patients
  e.g. acyclovir
  Topical antibiotic creams like mupirocin or soframycin help to prevent secondary bacterial infection.