Shingles Flashcards
What is shingles?
A viral disease caused by the human herpes virus 3 (HHV-3)
What is HHV-3 more commonly known as?
Varicella zoster virus (VZV)
When does shingles occur after infection with VZV?
After reactivation of primary infection that usually occurs during childhood
What does primary infection with VZV cause in children?
Chickenpox
What happens to the VZV after chickenpox has occurred?
It lays dormant in the sensory nervous system
What part of the sensory nervous systems does VZV lat dormant in?
The geniculate, trigeminal or dorsal root ganglia
How long can VZV lay dormant for?
Decades
What will happen when VZV is reactivated?
It will flare up in a single dermatome segment
How does VZV affect the dermatome?
It travels down the affected nerves over a period of 3-4 days, causing perineural and intraneural inflammation
What are the most commonly affected areas by shingles in immunocompetent patients?
- Thoracic nerve roots
2. Ophthalmic division of CN V
What is the danger of ophthalmic shingles?
It can progress to involve the entire eye
What things are associated with flare-ups of VZV causing shingles?
- Ageing
- Immunosuppressive illness
- Psychological or physical trauma
What age are most patients with shingles?
Over 50
What immunosuppressive illnesses can lead to flare up of shingles?
- HIV
- Hodgkin’s lymphoma
- Bone marrow transplants
What phases can shingles be divided into?
- Pre-eruptive phase
- Eruptive phase
- Chronic phase
What happens in the pre-eruptive phase of shingles?
- No skin lesions
- Burning, itching or paraesthesia in one dermatome
- Systemic symptoms
What systemic symptoms can be present in the eruptive phase of shingles?
- Malaise
- Myalgia
- Headache
- Fever
What happens in the eruptive phase of shingles?
- Skin lesions appear
- Acute neuritic pain
How do shingles lesions first appear?
As a patch of eryhtematous, swollen plaques with clusters of small vesicles affecting only one dermatome
What happens to shingles lesions over 7-10 days?
Crusting and drying
How long can resolution of shingles take?
14-21 days
When are shingles lesions no longer infectious?
Once the lesions have dryed