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Herpes zoster, colloquially known as shingles, is the reactivation of varicella zoster virus, leading to a crop of painful blisters over the area of a dermatome. In Italy and in Malta, it is sometimes referred to as St. Anthony's fire. Prior to implementation of the universal varicella vaccination program in the U.S., incidence of shingles increased with advancing age. The incidence rate in children aged less than 10 years was approximately 70 cases/100,000 person-years, increasing to 550 cases/100,000 person-years among adults aged 50 to 59 years. Historically, it was thought that shingles incidence increased due to an age-related decline in immunity; however, recent studies suggest that incidence of shingles is linked to the frequency of periodic exogenous (outside) exposures to children with varicella (chickenpox). These exposures produced an immunologic boost that helped suppress the reactivation of shingles. Shingles incidence is high in the elderly (over 60), as well as in any age group of immunocompromised patients. It affects some 1 million people per year in the United States and can involve excrutiating pain. Treatment is generally with antiviral drugs such as aciclovir. Many patients develop a painful condition called postherpetic neuralgia which is often difficult to manage.
In some patients, herpes zoster can reactivate subclinically with pain in a dermatomal distribution without rash. This condition is known as zoster sine herpete and may be more complicated, affecting multiple levels of the nervous system and causing multiple cranial neuropathies, polyneuritis, myelitis, or aseptic meningitis.
The word herpes comes from the Greek word for snake; it is cognate with herpetologyTreatment of Herpes Zoster with Fire Needle retrieved May 22, 2006.
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bobdigi_26 (royal higgs) Thu, 24 Dec 2009 22:56:50 -0000
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