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  Shingles

In the medical field, the layman’s term shingles is known as Herpes zoster. Although Herpes zoster has the same genus with the sexually transmitted disease, Herpes simplex causing herpes genitalis, there is no relation between the two groups of viruses. Herpes zoster presents as a skin rash, due to the reactivation of varicella zoster virus (VZV) which is the same virus causing the viral exanthem chickenpox. It has been postulated that after a patient recovered from chickenpox, the virus lives dormant in the nerves and will never be completely cleared out from the body. In certain instances such as emotional or physical stress, immune deficiency, chemotherapy or malignancy, the virus may reactivate causing shingles. Hence, shingles often appears among the elderly age group but occasionally in younger individuals. There is no sex predilection and the disease may appear all throughout the year.

Shingles Infectious diseases
Shingles


The diagnosis of shingle is clinical, based on the pathognomonic features of the skin lesions which are described as vesicular crops or blisters in clusters. In doubtful cases, fluid from a blister may be investigated in a clinical laboratory through a procedure called Tzanck smear.

The complains of patients suffering with shingles may range from several days to a week of burning, stinging pain and sensitive skin usually along a dermatomal line even before the rash appears. The distribution of the lesions is along a dermatome, an imaginary line following the path of the nerve involved in the skin. The lesions appear along a spinal nerve exiting from a particular level of the spinal cord. Shingles may begin as small blisters on an erythematous base, followed by eruption of new blisters which is zosteriform (dermtomal pattern) in distribution for 3-5 days. The blisters may or may not involve the entire path of the spinal nerve. In general, only a single spinal nerve is involved but rarely, some cases involve more than one spinal nerve. In time, the vesicular lesions rupture and the lesions start to have some oozing exudates until crusts are formed and eventually heal. The entire course of the illness may take around 3 to 4 weeks.

Postherpetic neuralgia is the most common complication of shingles which is more difficult to treat. This is a condition wherein the pain associated with the herpes zoster is longer and persists beyond one month. In these cases, the rash has disappeared but the pain remains. It is a consequence of continuous irritation of the sensory nerves by the virus. In patients over the age of 50, the pain can be so severe and debilitating affecting their activities of daily living. Treatment of shingles with steroids and antivirals can diminish the occurrence and shorten the duration of postherpetic neuralgia.

A predisposing factor for a patient to develop shingles later in life is when a person already had chickenpox in the past. Direct contact to an infected individual does not cause a reactivation of the dormant virus of another individual. However, patients with shingles may cause chickenpox in an individual who has not had chickenpox in the past.

Effective treatments for shingles include: antivirals, such as acyclovir and famciclovir. If the antiviral treatment is started early in the course of the illness, it can reduce the duration of the rash. Ideally, the treatment should be started within 48 hours of the appearance of the rash. In addition, steroids may also reduce the length of time that a patient feels the pain with herpes zoster. Pain relievers may be given for controlling the pain felt over the entire course of the illness. Although bathing is allowed especially cleaning the affected area with soap and water, at other times the area should always be kept covered and dry. Shingles is a self-limiting condition, most cases of shingles resolve spontaneously on their own even without specific treatment.

In cases where the affected area is along the upper half of the face, even if its mild, immediate medical attention is needed because there is some danger that the virus may involve the cornea of the eye that if damaged can lead to blindness. In other affected areas in the body, shingles is not usually life threatening to a healthy individual but it causes a lot of discomfort and distress during the acute phase of the illness. Rare complications include partial facial paralysis (usually transient), ear damage or encephalitis (inflammation of the brain secondary to the viral invasion).

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Valtrex capsules

Valtrex

Also called Valacyclovir, Valtrex is used to treat the symptoms of shingles, a herpes virus infection of the skin, and to treat and prevent genital herpes infections. Be sure to tell your doctor of any allergies you have whether it is to medication or more...

Valacyclovir pill

Valacyclovir

Valacyclovir is used to treat herpes zoster (shingles) in immunocompetent patients; treatment of first-episode genital herpes; episodic treatment of recurrent genital herpes; suppression of recurrent genital herpes and reduction of heterosex more...

Acyclovir

Acyclovir

Acyclovir is one of a class of medicines known as antivirals. Acyclovir is used to treat infections caused by certain viruses. Topical acyclovir is used to treat the symptoms of herpes infections of the skin, mucous membranes, and genitals. If you ar more...

Neurontin capsules

Neurontin

Neurontin, also known as Gabapentin, is used to help control some types of seizures in the treatment of epilepsy. It is also used to manage pain that occurs after shingles, a condition known as Postherpetic Neuralgia. Be sure to tell your doctor of any more...

Gabapentin capsules

Gabapentin

Gabapentin, also known as Neurontin is used to help control some types of seizures in the treatment of epilepsy. It is also used to manage pain that occurs after shingles, a condition known as Postherpetic Neuralgia. Be sure to tell your doctor of any more...

Zovirax

Zovirax

Zovirax is the brand name for acyclovir. Acyclovir is medication that is injected and used to treat the growth and spread of the herpes virus so that the body can defeat the infection. Acyclovir is an antiviral drug, it does not cure herpes, but decreas more...


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