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Herpes Zoster
Herpes Zoster is a painful, rash viral, contagious disease of the skin. It is not life-threatening, but the pain can make life unbearable. There is a possibility of recurrence in cases that are not properly treated.
The causative agent of the disease is the varicella zoster virus. It is more common in the elderly and people whose immune systems are weakened by diseases or medications.
Shingles can occur in any part of the body. However, its typical feature is that it affects the right or left half of the body and is not seen in the other half.
Vaccination may be recommended to prevent the disease. Vaccination reduces the incidence of the disease. Initiating treatment in the early period also reduces the possibility of complications. On the other hand, it allows the symptoms to be milder.
What is Varicelle zoster virus?
Varicella zoster virus belongs to the herpes virus group. Herpes viruses also cause a sexually transmitted disease called genital herpes, which is characterized by herpes in the genital areas. However, varicella zoster is not sexually transmitted.
Varicella zoster virus is also the causative agent of chickenpox. It remains silently in the brain or nerve tissues for many years after chickenpox. It reactivates at a time when the immune system is weakened and may develop shingles by passing from the nerves to the skin. Not everyone who has chickenpox develops shingles.
People with shingles can transmit the virus until their scabs heal. People who are not immune to chickenpox can develop chickenpox. Likewise, shingles can occur in these people after a long time.
It is not known exactly why the varicella zoster virus is reactivated after many years. The fact that the disease is more common in the elderly and people with weakened immune systems suggests that it may be due to the decrease in cells to fight the virus. For this reason, it attacks in cases of illness, aging, intense stress, extreme sadness, accident, poisoning, malnutrition, severe illness, corticosteroid treatment, cancer, chemotherapy, radiotherapy, organ transplantation, etc.
Vaccination is important in the prevention and treatment of the disease. It is recommended to apply chickenpox vaccine in childhood and shingles vaccine in old age. The shingles vaccine does not have 100% protection, but even if there is a disease, it prevents the disease from progressing mildly or the development of complications, and reduces the risk of transmission. The vaccine has no efficacy in the treatment of the disease.
Risk factors for Herpes Zoster:
- Age: People over the age of 50 are especially at risk for the disease. The risk increases with age. Some sources indicate that the majority of 80-year-olds may have shingles.
- Diseases: HIV/AIDS, cancer, blood diseases, etc. that weaken the person’s immune system. It increases the incidence of the disease.
- Drugs-treatment: Chemotherapy for cancer, radiotherapy, corticosteroid treatment, drugs that weaken the immune system may pave the way for the development of the disease.
- Surgical procedures: It is more common especially in patients who have weakened or weakened immune system, especially in patients who have undergone organ transplantation.
Symptoms:
- Headache,
- Weakness, Fatigue,
- Fire,
- Itching, redness, tingling sensation on the skin,
- severe pain,
- Rash (a few days after the symptoms start, it occurs anywhere on the body including the eyes or ears, but only on the right or left side, red or brown, watery lesions dry and crust after a while),
- Eye involvement, redness, itching, pain, vision problems,
Diagnosis of herpes zoster
The patient’s anamnesis and physical examination findings are usually sufficient for diagnosis. The localization of the rash, its occurrence on one side of the body, its shape and pain are investigated. In some patients, a sample of the rash can be taken for diagnosis and laboratory examination can be performed.
Treatment
Rashes heal in 2-4 weeks. However, complications can be permanent.
Initiation of antiviral therapy (acyclovir, famciclovir, valacyclovir, etc.) within the first 72 hours of the disease prevents exacerbation of rashes, itching and pain, shortens the duration of the disease and prevents the development of complications.
B vitamin supplements can be given for support purposes.
Antihistamines for itching, anesthetic creams, antiseptics to prevent infection, pain relievers for pain, eye ointments for eye complaints can be used. The use of antibiotics does not help, and may even prolong the healing time of the rash.
It is recommended to avoid alcohol during the illness. It is important that the lesions remain clean and dry against the risk of infection.
Cold shower for rashes, itching and pain, and cold compresses can be applied on lesions.
It is necessary to stay away from children under one year old, pregnant women, people with weakened immune systems and the elderly who have not been vaccinated against chickenpox in case of transmission of the virus. It is recommended to rest during the rash and not to go to work or school.
The shingles vaccine is recommended especially for people over 65 years of age to prevent the disease.
Complications
The disease is painful but usually has a good prognosis. However, some complications may occur. These complications are:
- Infections: Shingles lesions become sores over time, crusting and itchy. In cases where adequate hygiene conditions cannot be completed, wounds and itching also pave the way for some infections, especially skin infections.
- Vision problems: Shingles can be seen in the whole body area, as well as in the eyes. Severe pain, itching, tearing, decreased visual acuity, infections may develop in the eye.
- Post herpetic neuralgia: In shingles, pain may persist even if the lesions heal and the wound crusts over. This condition develops due to damage to the nerves. Damaged nerves continue to send pain messages.
- Nerve damage: Depending on the location of the shingles, nervous system damage may occur. Diseases such as encephalitis, hearing problems, facial paralysis may develop.