Shingles(대상포진)

 

Shingles (Herpes Zoster) = 대상포진

Definition

Shingles (herpes zoster) is a painful, blistering skin rash

due to the varicella-zoster virus, the virus that causes chickenpox.

Causes, incidence, and risk factors

After you get chickenpox, the virus remains inactive (becomes dormant)

in certain nerves in the body.

Shingles occurs after the virus becomes active again in these nerves years later.

The reason the virus suddenly become active again is not clear.

Often only one attack occurs.Shingles may develop in any age group,

but you are more likely to develop the condition if:

• You are older than 60
• You had chickenpox before age 1
• Your immune system is weakened by medications or disease

If an adult or child has direct contact with the shingles rash on someone and

has not had chickenpox as a child or a chickenpox vaccine,

they can develop chickenpox, rather than shingles.

Symptoms

The first symptom is usually one-sided pain, tingling, or burning.

The pain and burning may be severe and is usually present before any rash appears.

Red patches on the skin, followed by small blisters, form in most people.

• The blisters break, forming small ulcers that begin to dry and form crusts.
• The crusts fall off in 2 to 3 weeks. Scarring is rare.
• The rash usually involves a narrow area from the spine around to the front of the belly area or chest.
• The rash may involve face, eyes, mouth, and ears.

Additional symptoms may include:

• Abdominal pain
• Chills
• Difficulty moving some of the muscles in the face
• Drooping eyelid (ptosis)
• Fever and chills
• General ill-feeling
• Genital lesions
• Headache
• Hearing loss
• Joint pain
• Loss of eye motion
• Swollen glands (lymph nodes)
• Taste problems
• Vision problems

You may also have have pain, muscle weakness, and a rash involving

different parts of your face if shingles affects a nerve in your face.

See: Ramsay Hunt syndrome

Treatment

Shingles usually disappears on its own. You may only need treatment to relieve pain.

Your doctor may prescribe a medicine that fights the virus, called an antiviral.

The drug helps reduce pain and complications and shorten the course of the disease. Acyclovir, famciclovir, and valacyclovir may be be used.

The medications should be started within 24 hours of feeling pain or burning,

and preferably before the blisters appear. The drugs are usually given in pill form,

in doses many times greater than those recommended for herpes simplex or genital herpes.

Some people may need to receive the medicine through a vein (by IV).

Strong anti-inflammatory medicines called corticosteroids, such as prednisone,

may be used to reduce swelling and the risk of continued pain.

These drugs do not work in all patients.

Other medicines may include:

• Antihistamines to reduce itching (taken by mouth or applied to the skin)
• Pain medicines
• Zostrix, a cream containing capsaicin (an extract of pepper)
• to prevent postherpetic neuralgia

Cool wet compresses can be used to reduce pain. Soothing baths and lotions,

such as colloidal oatmeal bath, starch baths, or calamine lotion,

may help to relieve itching and discomfort.

Resting in bed until the fever goes down is recommended.

The skin should be kept clean, and contaminated items should not be reused. Nondisposable items should be washed in boiling water or otherwise

disinfected before reuse. The person may need to be isolated

while lesions are oozing to prevent infection of others -- especially pregnant women.

 

Expectations (prognosis)

Herpes zoster usually clears in 2 to 3 weeks and rarely recurs. If the virus affects

the nerves that control movement (the motor nerves),

you may have temporary or permanent weakness or paralysis.

Sometimes, the pain in the area where the shingles occurred may last

from months to years. See: Postherpetic neuralgia