Localization
The localization of the rash depends on the nerves involved and may occur on different areas of the body, including the face, chest, back, or legs. The disease can be divided into several stages, depending on the type and extent of the rash and the severity of the symptoms. Usually, the disease lasts two to four weeks, but may take longer in older people and people with weakened immune systems.
Therapy
Treatment for shingles includes the use of antiviral medications to reduce the severity and duration of the disease and the use of pain medications and anti-inflammatory medications to relieve pain and inflammation. In some cases, therapy may be needed to reduce the risk of complications.
Conditions similar to shingles include other diseases caused by the varicella-zoster virus, such as chickenpox. In addition, there are other diseases that have similar symptoms to shingles, such as herpes simplex or dermatitis.
Frequency
The incidence of shingles increases with age and is estimated to affect one in three people during their lifetime. Risk factors include age, gender, chronic illness, stress and certain medications. Vaccination can reduce the risk of contracting the disease, especially in the elderly and people with weakened immune systems.
Pathogenesis
The pathogenesis of shingles is not fully understood, but reactivation of the varicella-zoster virus is thought to occur due to a weakening of the immune system or other factors. The virus replicates in nerve cells and spreads along affected nerves, causing pain and a rash.
Overall, shingles is a painful disease that particularly affects the elderly and people with weakened immune systems. Early diagnosis and treatment can relieve symptoms and prevent complications. Vaccination can reduce the risk of contracting the disease, especially in the elderly and people with weakened immune systems.
Risk factors
Risk factors for shingles include age, gender (women appear to be at higher risk than men), a weakened immune system due to illness or medication, stress, smoking, and genetic factors. People who have already had a chickenpox infection are also at higher risk.
Prevention
Prevention of shingles includes vaccination, which is recommended for people over age 50 and for people with weakened immune systems or certain medical conditions. Vaccination reduces the risk of getting shingles and may also reduce the risk of complications.
Classification
The classification of shingles depends on the location of the rash. If the rash occurs on the face, it is called herpes zoster ophthalmicus. When it occurs on the chest, it is called herpes zoster thoracis. When it occurs on the lumbar region, it is called herpes zoster lumbalis. When it occurs on the legs, it is called herpes zoster femoralis. There are other forms of shingles, such as herpes zoster oticus, in which the rash occurs in the ear.
Staging
The staging of shingles usually occurs in three stages. In the first stage, there is pain, tingling or itching, which can often be accompanied by fatigue and fever. In the second stage, the rash appears, which consists of vesicles or pustules and is accompanied by pain. In the third stage, the vesicles heal and a crust forms, which disappears within two to four weeks.
The prognosis of shingles depends on several factors, including the age and health status of the patient and the severity of the disease. Usually, the disease heals without complications, but in rare cases, complications can occur, such as post-herpetic neuralgia (PHN), which causes pain and sensory disturbances and can last several months to years.
Related diseases
Similar diseases include chickenpox (varicella), which is caused by the same virus, and other viral infections such as herpes simplex, which can lead to cold sores.
Literature
Ragozzino MW, Melton LJ, Kurland LT, Chu CP, Perry HO. Population-based study of herpes zoster and its sequelae. Medicine (Baltimore). 1982;61(5):310-316. doi:10.1097/00005792-198209000-00004
Gilden DH. Clinical practice. Bell’s palsy. N Engl J Med. 2004;351(13):1323-1331. doi:10.1056/NEJMcp041120.
Cohen JI. Clinical practice. Herpes zoster. N Engl J Med. 2013;369(3):255-263. doi:10.1056/NEJMcp1302674.
Schmader K, Gnann JW Jr, Watson CP. The epidemiological, clinical, and pathological rationale for the herpes zoster vaccine. J Infect Dis. 2008;197 Suppl 2:S207-S215. doi:10.1086/522157.
Johnson RW, Bouhassira D, Kassianos G, Leplege A, Schmader KE, Weinke T. The impact of herpes zoster and post-herpetic neuralgia on quality-of-life. BMC Med. 2010;8:37. doi:10.1186/1741-7015-8-37.
Web links:
https://www.cdc.gov/shingles/index.html
https://www.nhs.uk/conditions/shingles/
https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054