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INSTITUTO DE DERMATOLOGÍA

DR. PABLO UMBERT

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HERPES ZOSTER

What is?

The varicella zoster virus is a type of human herpes virus that is transmitted from person to person. The first infection causes chickenpox and usually occurs in childhood. After you get chickenpox, the virus remains inactive (latent) in the ganglia. The virus may reactivate and cause the "Shingles" or shingles. Usually only happens once. Risk factors for reactivation are: Being over 60, having had varicella before 1 year of age, low immune system.

Clinical Manifestations

The first symptom is usually only pain, tingling or burning in one side, so it can be misdiagnosed with muscle contraction, heart attack, colic or a traumatic pathology. After 48 h of the onset of pain a spot (pink color) appears with small blisters. The blisters break, forming small ulcers that begin to dry and form scabs, which fall within two to three weeks and heal without scarring. The rash usually involves a narrow area from the spine around to the front of the belly area or chest, but there are cases in which it may affect the face, eyes, mouth and ears. If shingles affects the face, it can affect the facial nerve, which could give other symptoms such as difficulty moving some muscles of the face, hearing impairment and eye movement problems.

Diagnosis

Your dermatologist can diagnose it clinically by examining your skin and asking questions about your medical history. Rarely testing is needed, but these may include a cytology smean skin to see if it is infected with the virus.

Treatment for herpes zoster

Treatment consists of taking antiviral drugs taken orally, which help by reducing pain, prevents complications and shortens the course of the illness. Acyclovir, famciclovir, valaciclovir and brivudine may be used. It is important to start treatment as soon as possible, ideally the first 24 hours since the onset. In addition topical treatment can be prescribed to improve symptoms and prevent secondary infections of skin wounds. Also in case of pain analgesia may be considered. It is important that others who have not had chickenpox avoid direct contact with the lesions of herpes zoster, especially pregnant women, because they could develop chickenpox.

Pronostic

Eherpes zoster usually disappears in two to three weeks. Often the pain disappears later, and sometimes the pain in the area of shingles can last for months or years (PHN). Postherpetic neuralgia is more common in people over 60 years. It can be mild or very severe, and requires treatment during several months.

Doctor Pablo Umbert

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