Shingles - from simple ailments and brain damage

Shingles - a viral infection that causes a painful rash. Although it may appear on any part of the body, usually in the disease in the skin occurs from a strip of blisters around the upper body or on the right or left side.

The causative agent of herpes zoster is varicella zoster virus - the same virus that causes chicken pox, or the chickenpox. After the man had chickenpox, the virus becomes inactive and remains in the nerve tissues adjacent to the spinal cord and brain. Many years later he may again become active, causing symptoms of shingles.

This disease is not fatal, but it can be extremely painful. The vaccine can reduce the risk of shingles, and early onset of flow will shorten the duration of the active phase of the disease and reduce the risk of complications.

Shingles Ringworm - not only infectious disease   - A disease which is caused by reactivation of the virus chickenpox (Varicella zoster) - the causative agent of chickenpox. However, unlike chicken pox, shingles develops, not all people exposed to the virus and have no immunity, but only 10-20% of people infected with the virus. The incidence of herpes zoster increases rapidly with age, and doubles for each decade after 50 years. People younger than 15 years, the disease is rare. According to one study on patients aged over 55 years accounted for 30% of all cases of shingles, though they accounted for only 8% of all study participants. In children under the age of 14 accounted for only 5% of cases.

According to experts, the cause of more frequent reactivation of the varicella-zoster virus in middle-aged and elderly is a natural age-related weakening of cell-mediated immunity. Incidence high among people who have diseases that affect cellular immunity, such as human immunodeficiency virus (HIV) and certain malignancies. Long-term use of corticosteroids, chemotherapy and radiotherapy also increase the risk of shingles.

Among HIV-infected patients the incidence of shingles by 15% higher than among people who are not infected with HIV. At the same time, there is no evidence that the shingles accelerates the development of AIDS in HIV-infected. Shingles develops in approximately 25% of patients diagnosed with Hodgkin's lymphoma.

The probability of the disease shingles may also depend on the race. It is known that the risk of developing the disease in the black by about a quarter higher than in Caucasians.

Although shingles is not as contagious as chickenpox, sick people they can infect those who have not yet had chickenpox. The probability of infection for those living with patients in the same apartment, of approximately 15%.

Pathophysiology

Varicella zoster virus is a highly contagious DNA virus. At first contact with the organism having no immunity to the disease it causes chickenpox and penetrates into the dorsal ganglia of the spinal cord. Exactly how he gets there, and whether he lives in neurons or supporting cells, it is not yet clear. Anyway, varicella-zoster virus genome was detected in trigeminal ganglia virtually all patients tested for the presence of this virus were positive.

The virus remains latent for decades due to the acquisition at the time of primary infection cellular immunity. This is to some extent it contributes to strengthening the immune system Strengthening the immune system - help the immune system That occurs during the life of the external and internal reasons. Reactivation of the virus usually occurs when cellular immunity is becoming weaker. "Awake" virus moves to the nerve and causes pain and a rash. In some patients, the same virus leads to the development of post-herpetic neuralgia, but how this happens is unclear.

The clinical picture

The first step in the development of shingles is often a prodromal period, which is characterized by tingling, burning and increased sensitivity on the skin where the symptoms appear later; may be present and some other features. The duration of the prodromal period is usually one to two days, but in some cases it may take up to three weeks.

During the prodromal period shingles can be mistaken for some gynecological, cardiovascular disease, as well as disorders affecting the gastrointestinal tract.

Upon completion of this period, the skin appears characteristic shingles rash - first is a small papules, then - bubbles, which contain clear fluid. The rash is usually quite painful, its appearance is often accompanied by anxiety Anxiety - how to distinguish normal from disease?   and symptoms similar to flu symptoms.

The main complaint of patients suffering from herpes zoster, is a pain - which is why they often seek medical help. The pain can be described as a strong burning or stinging, and it can not cope on their own. In addition, many patients because of the pain having problems sleeping.

After about 7-10 days the bubbles burst, and in their place is formed dry crust. When she falls off, in its place may be small scars. Sometimes there is a change in skin pigmentation.

In some patients, shingles leads to complications affecting the eyes, among them - mucopurulent conjunctivitis, episcleritis, keratitis and anterior uveitis.

The most common chronic complication of shingles is postherpetic neuralgia. Soreness, persists for more than one to three months after the disappearance of a skin rash, generally considered a sign of this disorder. Such patients usually complain of a constant burning sensation and acute pain. Some of these pain may increase even with a small impact on the skin, for example, by contact with clothing, blankets, even when the wind blows.

In most cases, postherpetic neuralgia is a self-limiting disease - the symptoms eventually pass on their own. Less than a quarter of patients pain persists six months after the first symptoms of shingles; Only one out of twenty people are still suffering from pain a year later.

Symptoms

Symptoms often shingles usually affect certain areas of the body, and often appear only on one side. This disease can be identified by the following symptoms:

• Pain, burning, numbness or tingling of the skin
• The red rash that appears a few days after the onset of pain
• Blisters filled with fluid which burst after some time and are covered with a dry crust
• Itching
• Several less common in patients with herpes zoster, appear and symptoms:
• Fever (high body temperature, episodes of fever and chills)
• General malaise, body aches
• Headache
• Causeless tiredness, lethargy

The pain is usually the first symptom of shingles. In some patients, it may be very intense. Depending on the location of the pain is sometimes mistaken for a sign of heart disease, lung or kidney. In some patients, the pain is the only symptom of shingles - a rash they did not appear at all. In some cases, the rash does not appear on the trunk, and around one eye, around the neck or face.

When you need to see a doctor

If you suspect that the shingles do need to see a doctor, but in some cases it should be done immediately:

• If you have a pain and a rash on the skin around the eye. If untreated, it can lead to permanent eye damage.
• You are over 65 - this increases the risk of developing serious complications.
• You have a weakened immune system (due to cancer, drug therapy, or chronic disease).
• The rash spreads not a big area of ​​the skin and is very painful.

Causes

Shingles can occur in any person who has ever had chickenpox. Varicella zoster virus may remain dormant phase for decades; some patients he never reactivated.

It is not clear why it sometimes causes shingles. Most scientists believe that to blame a weakened immune system. This can happen for a variety of reasons - from chronic emotional stress How to beat stress? Create an oasis   and drug therapy, completing the natural process of aging.

Is it contagious?

A person with shingles can pass the virus varicella-zoster anyone who does not have immunity to chickenpox - that is, those who never got sick of it. This usually occurs by direct contact with open wounds, blisters appearing on the site. Once infected, a person sick with chickenpox, not shingles.

For some, chickenpox can be dangerous, so patients who have burst on the skin blisters should avoid physical contact with:

• People whose immune system is weakened (this includes, for example, patients undergoing chemotherapy and radiotherapy, HIV-infected patients with certain chronic diseases)
• Newborns
• Pregnant women