Herpes zoster commonly known as shingles, is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. The initial infection with varicella zoster virus causes the acute illness chickenpox, and generally occurs in children and young people. Once an episode of chickenpox has resolved, the virus is not eliminated from the body but can go on to cause shingles; an illness with very different symptoms; often many years after the initial infection.
Shingles is a skin rash caused by the same virus that causes chickenpox. This virus is called the Varicella zoster virus (VZV) and is in the Herpes family of viruses. After an individual has chickenpox, this virus lives in the nervous system and is never fully cleared from the body. Under certain circumstances, such as emotional stress, immune deficiency (from AIDS or chemotherapy), or with cancer, the virus reactivates and causes shingles. In most cases of shingles, however, a cause for the reactivation of the virus is never found.
In an immunocompromised individual, perhaps years or decades after a chickenpox infection, the virus may break out of nerve cell bodies and travel down nerve axons to cause viral infection of the skin in the region of the nerve. The virus may spread from one or more ganglia along nerves of an affected segment and infect the corresponding dermatome (an area of skin supplied by one spinal nerve) causing a painful rash. Although the rash usually heals within two to four weeks, some sufferers experience residual nerve pain for months or years, a condition called postherpetic neuralgia.
Anyone who has ever had chickenpox is at risk for the development of shingles, although it occurs most commonly in people over the age of 60. The herpes virus that causes shingles and chickenpox is not the same as the herpes viruses that causes genital herpes (which can be sexually transmitted) or herpes mouth sores. Shingles is medically termed Herpes zoster.
â€¢ Varicella zoster virus.
SITE OF PATHOLOGY
â€¢ Posterior root ganglion.
â€¢ Physical injury.
â€¢ Mental trauma.
â€¢ Febrile illness.
â€¢ Any condition decreasing local skin resistance.
â€¢ Adults, old subjects.
â€¢ 7-21 days.
CLINICAL FEATURES of Herpes Zoster
â€¢ Trunk (intercostal nerves).
â€¢ Face (trigeminal distribution).
â€¢ Neck (cervical).
The first symptom is usually one-sided pain, tingling, or burning. The pain and burning may be severe.
Red patches on the skin form, followed by small blisters that look very similar to early chickenpox. The blisters break, forming small ulcers that begin to dry and form crusts. The crusts fall off in 2 to 3 weeks.
The rash usually involves a narrow area from the spine around to the front of the belly area or chest. It may involve face, eyes, mouth and ears.
Additional symptoms may include:
â€¢ Abdominal pain
â€¢ Difficulty moving some of the muscles in the face
â€¢ Drooping eyelid (ptosis)
â€¢ General ill-feeling
â€¢ Genital lesions
â€¢ Hearing loss
â€¢ Joint pain
â€¢ Loss of eye motion (ophthalmoplegia)
â€¢ Swollen glands (lymph nodes)
â€¢ Taste problems
â€¢ Vision problems
â€¢ Severe neuralgic pain.
â€¢ Local hyperaesthesia.
â€¢ Develop 3 days after onset of attack.
â€¢ Start as reddish plaques.
â€¢ Unilateral distribution, along segmental distribution of affected nerve root.
â€¢ Crops of vesicles appear.
â€¢ Speedily increase in size.
â€¢ Become confluent.
â€¢ Vesicles contain serous fluid.
â€¢ In few days content become opaque.
â€¢ Absorption of contents occurs.
â€¢ Brown adherent crusts form.
â€¢ In few weeks crusts separate leaving pigmented scars.
â€¢ Regional lymph glands enlarged, painful.
Involvement of the facial nerve may cause Ramsay Hunt syndrome, which can lead to loss of movement in the face, hearing loss, loss of taste, and other symptoms.
Other complications may include:
â€¢ Another attack of shingles
â€¢ Blindness (if lesions occur in the eye)
â€¢ Infection, lesions in body organs, encephalitis or sepsis in persons with weakened immune systems
â€¢ Post-herpetic neuralgia
â€¢ Secondary bacterial skin infections
â€¢ Ramsay-hunt syndrome (if geniculate ganglion is affected).
â€¢ Corneal ulceration (if ophthalmic division is affected).
GENERAL MANAGEMENT of Herpez zoster / Shingles
â€¢ Light, nutritious, easily digestible diet.
â€¢ Keep affected parts clean.
â€¢ Adequate physical, mental rest.
â€¢ Arsenicum album.
â€¢ Hepar sulph.
â€¢ Mercurious solubilis.
â€¢ Ranunculus bulbosus.
â€¢ Rhus toxicodendron.
Homeopathic Remedies for Herpes zoster or Shingles
Herpes typically affects the lips, the face and intercostal region. The eruptions are confluent ith intense burning sensation in the blister. Patient is worse after midnight and from cold in any form. Patient feels better by warmth. Associated with herpes, patient feels very thirsty and gets prostrated very easily. Herpetic eruptions alternate with internal affections.
Great Prostration, with rapid sinking of the vital forces; fainting. The disposition is:
a. Depression, melancholy, despairing, indifferent.
b. Anxious, fearful, restless, full of anguish.
c. Irritable, sensitive, peevish, easily vexed.
The greater the suffering the greater the anguish, restlessness and fear of death. Mentally restless, but physically too weak to move. Indicated by its periodicity and time aggravation: after mid-night, and from 1-2 a.m. And by its intense restlessness, mental and physical: its anxiety and prostration.