Shingles

• Caused by reactivation of the Varicella-Zoster Virus (VZV), the same virus responsible for chickenpox.
• After a past chickenpox infection, the virus remains dormant in nerve ganglia and can reactivate years later when immunity declines.

• Painful red rashes and blisters appear in a band-like pattern on one side of the body, following the affected nerve.
• Commonly occurs in older adults or individuals with weakened immune systems.
• Pain may precede the rash by several days, often described as burning, tingling, or stabbing.

• The most frequent complication is postherpetic neuralgia (PHN), where nerve pain persists for weeks or months after the rash heals.

• Based on the characteristic rash distribution and pain pattern along a single nerve (dermatome).
• Laboratory confirmation is rarely needed but can include VZV PCR or antigen testing in atypical cases.

• Early antiviral therapy (within 72 hours of onset) helps reduce pain, shorten healing time, and lower the risk of nerve damage.
• Pain management with analgesics, nerve pain medications, or topical agents as needed.

• A zoster vaccine is recommended for adults aged 50 and older to reduce the risk of shingles and postherpetic neuralgia.