SHINGLESSHINGLES

Presented By : Areeba AzeemPresented By : Areeba Azeem

ShinglesShingles

Also known as Herpes Zoster.

An acute viral infection  of the nerve cells and surrounding skin.

Characterized by a rash of blisters, can be very painful but is not life-threatening.

Caused by the varicella zoster virus that also causes chickenpox.

• Shingles usually appears, band of blisters on one side of the chest or back, but it can occur anywhere on the body, including on the face and near the eyes.

Varicella-zoster virus

Varicella-zoster virus (VZV) infection causes two clinically distinct forms of disease:

1. Varicella (chickenpox)

1. Herpes zoster (shingles)

Herpes virus (DNA)

Primary infection results in varicella (chickenpox)

Recurrent infection results in herpes zoster (shingles)

Shingles EpidemiologyShingles Epidemiology

PathophysiologyPathophysiology

Clinical presentation of Clinical presentation of shingles shingles

Initial prodromal stageInitial prodromal stage

The first signs of shingles may include Headache

Feeling generally unwell

Myalgia

Fever 

Acute stage A rash will begin to develop, often

causing a pain.

Itching or tingling sensation in the area of the affected nerve.

A fluid filled painful rash then develops a few days after and commonly occurs either on one side of the face or body.

Fluid-filled blisters that break open and crust overin 7-10 days and this clears within 2-4 weeks.

Complications Of Complications Of ShinglesShingles

1.1. Post herpetic neuralgia Post herpetic neuralgia (PHN)(PHN)

Post herpetic neuralgia can cause severe nerve pain that persists after the rash. PHN occurs most often in elderly people and in people whose immune systems have been compromised.

2.2. Ophthalmic shinglesOphthalmic shingles

Shingles in or around an eye can cause painful eye infections that may result in vision loss.

3.3. Ramsay Hunt syndromeRamsay Hunt syndrome

Otherwise known as herpes zoster oticus, is inflammation of several of the nerves that come out of the brain. The symptoms of Ramsay Hunt syndrome are facial paralysis, ear pain.

4.Encephalitis

5.Hearing problems

6.Bacterial infections on the skin.

Treatment Of Herpes ZosterTreatment Of Herpes Zoster

Pharmacologic Pharmacologic ManagementManagement

Management of acute Management of acute herpes zosterherpes zoster Antiviral medication Antiviral medication to reduce

pain and complications. Should be started within 24 hours of first symptom  .These medications include:

Acyclovir (Zovirax) Valacyclovir (Valtrex) Famciclovir (Famvir)

Management of Post herpetic NeuralgiaTricyclic antidepressants, such

as amitriptyline.Opoids, such as methadone,

morphine. Lidocaine patch.Anticonvulsants, such as

gabapentin.Capsaicin cream.Topical anesthetics, including

benzocaine.

Non-pharmacologic treatment

Apply cool water compresses to the skin or soak in a bathtub filled with cool water

Add finely ground oatmeal to the bathtub.

Apply calamine lotion to the affected areas.

Trim your fingernails to avoid infection.

Wear loose-fitting clothing.

Preventiono Shingles vaccine (ZostavaxShingles vaccine (Zostavax))

It is given to people 60 years of age and older who have already had the chickenpox.

The shingles vaccine is a live vaccine given as a single injection, usually in the upper arm. The most common side effects of the shingles vaccine are redness, pain, tenderness and swelling at the injection site, and headaches.

References:References: http://www.nytimes.com/health/guides/disease/herpes-

zoster/treatment-for-an-acute-shingles-attack.html http://www.wikihow.com/Treat-Shingles-(Herpes-Zoster) https://umm.edu/health/medical/altmed/condition/

varicellazoster-virus http://www.nhs.uk/Conditions/Shingles/Pages/

Treatment.aspx http://www.cdc.gov/vaccines/vpd-vac/shingles/hcp-

vaccination.htm http://www.nhs.uk/Conditions/Shingles/Pages/

Treatment.aspx http://www.mayoclinic.org/diseasesconditions/shingles/

basics/definition/con-20019574

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