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 appears as a single, wide stripe on either the left or right side of the body or face. Two to four days before the rash develops, patients may experience tingling or localized pain in the affected area. Some individuals, however, may only have fever, headache, or fatigue without the classic rash. The rash usually heals within two to four weeks; however, some people develop ongoing nerve pain that can last for months or years—this condition is called postherpetic neuralgia (PHN). In individuals with weakened immune systems, the rash may be more widespread. If the rash involves the eye, vision loss can occur. About one‑third of people will experience herpes zoster at some point in their lives. While it is more common in older adults, children can also develop the disease.

Chickenpox, also called varicella, results from the initial infection with the virus, typically occurring during childhood or adolescence. After chickenpox resolves, the virus can remain dormant in nerve cells for years or decades before reactivating. Herpes zoster occurs when the dormant varicella virus is reactivated, travels along nerve fibers, and reaches the skin, producing blisters. During a herpes zoster outbreak, exposure to the varicella virus present in the blisters can cause chickenpox in someone who has never had the disease.

Risk factors for reactivation of the dormant virus include older age, impaired 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 herpesvirus family.

Herpes zoster vaccines reduce the risk of developing the disease by 50 % to 90 %. They also lower the incidence of postherpetic neuralgia and, if herpes zoster does occur, lessen its severity. If herpes zoster develops, antiviral medications such as aciclovir can reduce the severity and duration of the illness when started within 72 hours of rash onset.

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

#Gabapentin
#Pregabalin
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  • 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.
  • Scarring can occur after herpes zoster and may persist for a long time, even after the virus has been cleared from the body.
  • When the forehead is involved, it is often accompanied by a headache. If the lesion involves the area around the nose, it is important to ensure 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, crusting and erythema may persist for more than a month.
  • Shingles can leave scars even after it has healed.
  • 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.