Shingles?! Prevention and management.    Shingles is also called herpes zoster and it is caused by the reaction of the chickenpox virus (aka varicella zoster virus).  One million cases of shingles occur annually in the US.  We each have an individual lifetime risk of 30% to contract this.  Patients with immunosuppression are more at risk for shingles.

The symptoms that may occur before a rash include malaise, headache, low-grade fever, and abnormal skin sensation starting 2-3 days before the rash becomes evident.

What are the hallmarks of shingles?  It is a unilateral (one side of the body), dermatomal (see the diagram), and typically progresses to clear blisters that become cloudy and then crust over with a scab in 7-10 days.

How to treat shingles?  Antiviral pills, if started before 72 hours of the onset of the rash, are known to decrease the length of time the rash is present.

What is postherpetic neuralgia?  It is the after-shingles-nerve-pain that is present more than 90 days after the rash resolves.  This occurs in 1 in 5 patients.

What is treatment?  Treatment is aimed to control the symptoms and includes topical creams (lidocaine and capsaicin) and oral pills like gabapentin, pregabalin and tricyclic antidepressants.

What is my opinion of the varicella zoster vaccine?  I think it’s great.  It is approved for adults 50 years and older.  Search my blog on Shingrix vaccine for more information.