What is Shingles?

Thanks to my patient for allowing me to use her photo to talk about a common condition known as Shingles. Â The medical name is herpes zoster and it is caused by the re-activation of the chickenpox virus (varicella zoster). Â This crazy virus lays dormant in the nerves and something causes it to flare up years or decades later.

The first signs of the rash
This patient noticed a small rash behind her right ear and thought it was insect bites after a camping trip. Â She had some tingling (a common sign) and swollen and tender lymph nodes. Â Two days later when I saw her, the rash had spread down her neck and shoulder and she definitely had lymph node swelling at the neck and above the clavicle. (nuchal and supraclavicular nodes). Â She had no fever but felt a little down.
Most shingles occurs in older people but it is not uncommon in younger folks too, like this patient.
The rash takes about a week to develop and can last about 2 weeks with varying degrees of pain and annoying tingling. Â Some patients have pain that lasts in the nerves long after the rash has resolved.
We treat Shingles with antiviral medication (Valcyclovir ) and pain control. Â People over the age of 60 are recommended to get Zostavax vaccine to help prevent an outbreak. Â It reduces the chances of Shingles by 51% and even higher reduction of post-herpetic neuralgia pain.
No special tests are needed to make the diagnosis. This is another reason everyone should have a primary care physician who can make the diagnosis and get the patient started on treatment.