Shingles (aka [herpes] zoster, aka zona) is a viral disease involving a painful skin rash w/ blisters involving a limited area.

• Rash, occurs:
  • On either the L or R of the body or face in a single stripe
  • Disseminated shingles (rash occurs widely), in those who are immunosuppressed
  • Usually heals within 2-4 weeks
• Pain or tingling in the area, 2-4 days before the rash occurs
• Otherwise typically few Sx

• Chickenpox is due to an intial infection w/ ZVZ. Once chickenpox has resolved, the viru smay remain inactive in nerve cells
• Shingles is due to REactivation of varicella zoster virus (VZV) within a Pt's body
• VZV is not the same as HSV, however, they belong to the same family of viruses, herpesviridae

• Older age
• Immunosuppression
• Having had chickenpox <18mo of age
• Exposure to the virus in the blisters can cause CHICKENPOX in someone who hasn't had it before, but will NOT trigger shingles

• Sx

• Shingles vaccine, decreaese chance of shingles by 50% in those between 50-80yo. It also decreases rates of postherpetic neuralgia, and if an outbreak occurs, its severity. >80yo, the vaccine is still effective, just less so. The vaccine contains the same material as the varicella vaccine, just at a higher dose
• Antiviral drugs, e.g. aciclovir, can reduce the severity and duration of disease if started <72 hours of the appearance of the rash
• Paracetamol, NSAID's or opioids, to help w/ acute pain
• Antivirals and steroids do NOT significantly effect rates of postherpetic neuralgia

• Postherpetic neuralgia (i.e. ongoing nerve pain which may last for months or years), in some patients

• 33% of people develop shignles at some point in their life
• Whilst it is more common amongst older Pt's, kids may also get the disease
• Incidence is 0.2% in health individuals, and 0.7% in those >65yo
• 50% of those living to 85yo wil have at least one attack, and <5% will have more than 1 attack

• Herpes SIMPLEX virus (same family of virus, but do not confuse)