Herpes zosterhttps://en.wikipedia.org/wiki/Shingles
Herpes zoster is a viral disease characterized by a painful skin rash with blisters in a localized area. Typically the rash occurs in a single, wide stripe either on the left or right side of the body or face. Two to four days before the rash occurs there may be tingling or local pain in the area. Otherwise, some patients may just have fever or headache, or feel tired without the typical rash. The rash usually heals within two to four weeks; however, some people develop ongoing nerve pain which can last for months or years, a condition called postherpetic neuralgia (PHN). In those with poor immune function the rash may occur widely. If the rash involves the eye, vision loss may occur. It is estimated that about a third of people suffer herpes zoster at some point in their life. While herpes zoster is more common among older people, children may also get the disease.

Chickenpox, also called varicella, results from the initial infection with the virus, typically occurring during childhood or adolescence. Once the chickenpox has cured, the virus can remain inactive (dormant) in human nerve cells for years or decades, after which it may reactivate. Herpes zoster results when the dormant varicella virus is reactivated. Then the virus travels along nerve bodies to nerve endings in the skin, producing blisters. During an outbreak of herpes zoster , exposure to the varicella virus found in herpes zoster blisters can cause chickenpox in someone who has not yet had chickenpox.

Risk factors for reactivation of the dormant virus include old age, poor immune function, and having contracted chickenpox before 18 months of age. Varicella zoster virus is not the same as herpes simplex virus, although both belong to the same family of herpesviruses.

Herpes zoster vaccines reduce the risk of herpes zoster by 50% to 90%. It also decreases rates of postherpetic neuralgia, and, if herpes zoster occurs, its severity. If herpes zoster develops, antiviral medications such as aciclovir can reduce the severity and duration of disease if started within 72 hours of the appearance of the rash.

○ Treatment
If the lesions are spreading rapidly, see your doctor as soon as possible for antiviral treatment.
Both antiviral drugs and neuralgia medications are required. You should rest and stop drinking alcohol.
#Acyclovir
#Fancyclovir
#Valacyclovir

#Gabapentin
#Pregabalin
  • Herpes zoster blisters on the neck and shoulder
  • Shingles ― Day 5; If treatment is initiated, the symptoms of the disease typically stop around five days later.
  • In cases of widespread herpes zoster, if antiviral treatment is delayed, the patient may suffer from painful blisters for an extended period.
  • Scars may result from herpes zoster, which can last a long time, even if the herpes virus in the body disappears.
  • If the forehead is affected, it is often accompanied by a headache. If the lesion has affected the area around the nose, it is important to check that your vision is normal.
  • This case demonstrates the typical dermatomal distribution of shingles.
  • Shingles ― Day1
  • Shingles ― Day2
  • Shingles Day6 ― The crust and scarring may persist for more than a month, although the lesion no longer progresses.
  • In the late stage of herpes zoster, crust and erythema may last for more than one month.
  • Shingles can leave scars even after being cured.
  • Shingles; scars
References Herpes Zoster and Postherpetic Neuralgia: Prevention and Management 29431387
Shingles, caused by the reactivation of the varicella zoster virus responsible for chickenpox, affects around 1 million people annually in the United States, with a lifetime risk of 30%. Those with weakened immune systems are significantly more prone to developing shingles, with symptoms typically starting with malaise, headache, and a mild fever, followed by unusual skin sensations a few days before the appearance of a rash. This rash, usually appearing in a specific area of the body, progresses from clear blisters to crusted sores over a week to ten days. Prompt treatment with antiviral medications (acyclovir, valacyclovir, or famciclovir) within 72 hours of rash onset is crucial. Postherpetic neuralgia, a common complication characterized by prolonged pain in the affected area, affects about one in five patients and requires ongoing management with medications such as gabapentin, pregabalin, or certain antidepressants, along with topical agents like lidocaine or capsaicin. Vaccination against the varicella zoster virus is recommended for adults aged 50 and above to reduce the risk of shingles.
 Epidemiology, treatment and prevention of herpes zoster: A comprehensive review 29516900
Herpes zoster tends to occur more frequently in people aged 50 and older, those with weakened immune systems, and those taking immunosuppressant medications. It's triggered by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Symptoms like fever, pain, and itching commonly precede the appearance of the characteristic rash. The most common complication is post-herpetic neuralgia, which is persistent nerve pain after the rash clears up. The risk factors and complications associated with herpes zoster vary depending on age, immune health, and timing of treatment initiation. Vaccination for individuals aged 60 and above has been shown to significantly reduce the occurrence of herpes zoster and post-herpetic neuralgia. Starting antiviral medications and pain relievers within 72 hours of rash onset can lessen the severity and complications of herpes zoster and post-herpetic neuralgia.
 Prevention of Herpes Zoster: A Focus on the Effectiveness and Safety of Herpes Zoster Vaccines 36560671 
NIH
The pre-licensure clinical trials show the efficacy of the live zoster vaccine to be between 50 and 70% and for the recombinant vaccine to be higher at 90 to 97%. Real-world effectiveness studies, with a follow-up of approximately 10 years, were reviewed in this article. These data corroborated the efficacy studies, with vaccine effectiveness being 46% and 85% for the live and recombinant vaccines, respectively.