Herpes zoster (shingles) results from reactivation of the varicella-zoster virus. Herpes zoster is a sporadic disease with an estimated lifetime incidence of 10 to 20 percent. The incidence of herpes zoster increases sharply with advancing age, roughly doubling in each decade past the age of 50 years. Herpes zoster is uncommon in persons less than 15 years old.
Pathophysiology
Varicella-zoster virus is a highly contagious DNA virus. Varicella represents the primary infection in the nonimmune person. During the primary infection, the virus gains entry into the sensory dorsal root ganglia, where the virus remains latent for decades. Reactivation of the virus occurs following a decrease in virus-specific cell-mediated immunity. The reactivated virus causes a dermatomal distribution of pain and skin lesions.
Although herpes zoster is not as contagious as the primary varicella infection, persons with reactivated infection can transmit varicella-zoster virus to nonimmune contacts. About 20 percent of patients with herpes zoster develop postherpetic neuralgia. The most established risk factor is age; this complication occurs nearly 15 times more often in patients more than 50 years of age.
Clinical evaluation
Herpes zoster typically presents with a prodrome consisting of hyperesthesia, paresthesias, burning dysesthesias or pruritus along the affected dermatome(s). The prodrome generally lasts one to two days but may precede the appearance of skin lesions by up to three weeks.
The skin lesions begin as a maculopapular rash that follows a dermatomal distribution in a “belt-like pattern.” The maculopapular rash evolves into vesicles with an erythematous base. The vesicles are painful, and their development is often associated with the occurrence of flu-like symptoms. Although any vertebral dermatome may be involved, T5 and T6 are most commonly affected. The most frequently involved cranial nerve dermatome is the ophthalmic division of the trigeminal nerve. The vesicles crust over within seven to 10 days.
Postherpetic neuralgia is defined as pain that persists for longer than one to three months after resolution of the rash. Affected patients usually report constant burning, lancinating pain. Symptoms tend to abate over time. Less than one quarter of patients still experience pain at six months after the herpes zoster eruption, and fewer than one in 20 has pain at one year.
November 7th, 2007 at 4:49 am
Seeing from the article, there are also many people living with Shingles, but why there is no topic about shingles at blog and forum area of STD dating site pozgroup.com? Though there are many topics about HSV1 & HSV2.