Definition
Herpes zoster is an acute, localized infection with varicella-zoster virus, which causes a painful, blistering rash.
Alternative Names
Shingles
Causes, incidence, and risk factors
Herpes zoster, or shingles, is caused by the same virus that causes chickenpox. After an episode of chickenpox, the virus becomes dormant in the body. Herpes zoster occurs as a result of the virus re-emerging after many years.
The cause of the re-activation is usually unknown, but seems to be linked to aging, stress, or an impaired immune system. Often only one attack occurs, without recurrence.
If an adult or child is exposed to the herpes zoster virus and has not had chickenpox as a child or received the chickenpox vaccine, a severe case of chickenpox may develop, rather than shingles.
After infection with chickenpox, the virus resides in a non-active state in the nerve tracts that emerge from the spine. When it is re-activated, it spreads along the nerve tract, first causing pain or a burning sensation.
The typical rash appears in 2 to 3 days, after the virus has reached the skin. It consists of red patches of skin with small blisters (vesicles) that look very similar to early chickenpox. The rash often increases over the next 3 to 5 days. Then, the blisters break, forming small ulcers that begin to dry and form crusts. The crusts fall off in 2 to 3 weeks, leaving behind pink healing skin.
Lesions typically appear along a single dermatome (the body area served by a single spinal nerve) and are only on one side of the body (unilateral).
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