Shingles (Herpes Zoster)
Shingles is a painful blistering rash from reactivation of varicella-zoster virus, typically in a single dermatomal band on one side of the body.
Symptoms
Burning or shooting pain followed by grouped vesicles confined to one dermatome. Postherpetic neuralgia -- persistent pain after rash healing -- is the most common complication.
Causes and risk
The virus reactivates when cellular immunity wanes. Age over 50, immunosuppression, and stress increase risk. Shingrix vaccine reduces incidence by over 90%.
How it is evaluated
Clinical when dermatomal rash is present. PCR confirms atypical cases. We assess for eye involvement and Ramsay Hunt syndrome.
Treatment
Oral valacyclovir started within 72 hours reduces severity and neuralgia risk. Gabapentin or pregabalin manages pain. Our Chicago team counsels on Shingrix vaccination.