22 April, 2010

Herpes zoster (Shingles)

1) What is Herpes zoster (Shingles)  ?
small blisters with itching and burning pain
----- a stripe or belt-like pattern along with rib.

2)  Commonly occurs on the torso(65%), but can appear on the face, eyes (20%)
-------or other parts of the body(15%).  

Herpes zoster(the orbit of the eye and frontal head;
 the ophthalmic division of the trigeminal nerve)
 --------------Ramsay Hunt syndrome: if affect the facial nerve to the 
vestibulocochlear nerve, resulting the hearing loss and vertigo.

Herpes zoster(back region)
Herpes zoster(Thigh region)

3)  The causative agent: Varicella zoster virus (=VZV )
Electron-microscopic image(white bar=100nm)

Herpes zoster occurs only in person who suffered from Chickenpox.  
After recovered, the virus live in the spinal nerve ganglia( There are 8 cervical nerves, 
12 thoracic nerves, 5 lumbar nerves and 5 sacral nerves) adjacent to the spinal cord.
When a person have a stress or aging, the VZV is reactivated and go through the
nerve and rise to the skin regions.

4) Age: the majority of sufferers are older persons. Rare in infant.

5) Treatment )   i) Topical ointment: the mixture of 10% Zinc oxide and 2% phenol.
---------------- -ii) Antiviral drugs:  Acyclovir, Valaciclovir
----------------- The rash and pain usually subside within one month in child, but 
--------------------- some elderly patients develops a painful condition. In such case,
----------------------Please ask doctors.

Any questions:    write to      Keiji Hagiwara, MD
---------------------------------Kami-Ube Pediatric Clinic,
---------------------------------Ube 755-0097, Japan