Herpes zoster (also known as shingles) is caused by the varicella virus, the same virus that causes chicken pox in children and young adults.
The initial manifestation of the infection is normally pain which may be aching, sharp, constant, or recurrent along the course of the nerve. Patients often feel like they have pulled a muscle, slept in an unnatural position the night before, or are developing a cold in the back. This feeling lasts for 2-7 days, and the skin becomes quite sensitive to touch during this period. Red patches start to appear in the involved area followed by closely grouped papulovesicular lesions identical to lesions of chicken pox. The blister becomes cloudy then purulent (pimple-like) followed by crusting and scabbing. These lesions are confined to one dermatome and do not cross midline.
By far, the most serious complication of herpes zoster is lingering pain, referred to neuralgia. This pain can last months to years, and can be quite debilitating, especially in older patients.
Treatment of Herpes Zoster
Systemic therapy is readily available but requires early aggressive management to be treated effectively.