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S H I N G L E S(HERPES ZOSTER)
What is SHINGLES?
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Shingles is an acute infection andpainful viral disease of the peripheralnervous system in which a rash of smallblisters develops on the skin overlyingsensory nerve trunks.
What CAUSES the disease? 
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Shingles is caused by the
varicella-zoster virus
, the same virus thatcauses chicken pox.
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While the exact cause of shingles is notunderstood, scientists theorize that duringan attack of chicken pox, the virus mayinvade large clusters of 
neurons
(nervecells) found on either side of the spinalcord.
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The virus may live
dormant
withinthese neurons for years, held in check bythe body’s immune system.
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But if the immune system becomesimpaired, perhaps during the normal agingprocess or as a result of disease, the viruscan
reactivate
, causing neurons tobecome inflamed.
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Blisters
develop on the skin that liesabove the inflamed neurons.
Predisposing Factors?
People over 50 years.
Immunocompromisedpatients (e.g., AIDSpatients).
Age-related weakening of the immune system.
The disease may also resultfrom overwork, debility or weakness, damp and chillyweather, absorption of certain drugs paricularlycompounds of arsenic, or contact with a case of chicken pox.
Common Signs and Symptoms
■
In a typical attack of shingles, aperson first feels pain in the areathat will later break out in blisters.
■
Other initial symptoms includefever, headache, muscle soreness,fatigue, stomach upset, anddiarrhea.
■
After three to five days of theseinitial symptoms, the blistersappear, often accompanied byburning and tingling. The blistersare usually confined to one side of the body, most commonly in anarea extending from the upper half of the spine to the breastbone. Theface, abdomen, arms, and legs mayalso be affected. The rash usuallygoes away after a few weekswithout complications.
ManagementMedical/Therapeutic:
~ If available and as ordered, compressesmoistened with Burow’s solution (5%aluminum acetate solution) may beapplied to the affected skin areas for 15 to20 minutes a day. At other times, calaminelotion may be applied sparingly to relieveitching.~ If the skin breaks, the use of Bacitracintopical ointment will help to preventinfection as as prescribed.~ Corticosteroid medication as prescribedmay be administered during the acutephase of illness.~ As available and as ordered, an electricheating pad may be applied to the painfularea to relieve some of the discomfort.~ A lidocaine patch, a stretchy bandagecoated with a long-acting topicalanesthetic, may be applied to the painfularea to numb affected nerve endings andtemporarily relieve pain. In addition, aphysician may prescribe antidepressantsand other drugs that help calm inflamednerves, lessening pain.~ When shingles is diagnosed in patientswith suppressed immune systems, suchas those with acquired immunodeficiencysyndrome (AIDS) or cancer, the antiviraldrug acyclovir may be prescribed.
Home management:
~ Remain inactive for 7-14 days while thediscomfort is severe.~ DO NOT OPEN blisters that appear onthe skin.~ It is best to consult a physician in allcases of shingles.
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