About Shingles
Shingles (herpes zoster) are an outbreak of rash or blisters
on the skin that is caused by the same virus that causes
chicken pox - the varicella-zoster virus. The first sign of
shingles is often burning or tingling pain, or sometimes
numbness, in or under the skin.
You may also feel ill with fever, chills, headache, or upset
stomach. After several days, a rash of small fluid-filled
blisters, reminiscent of chickenpox, appears on reddened skin.
The pain associated with shingles can be intense and is often
described as "unrelenting."
Anyone who has had chickenpox is at risk for shingles.
Scientists think that in the original battle with
varicella-zoster, some of the virus particles leave the skin
blisters and move into the nervous system.
When the varicella-zoster virus reactivates, the virus moves
back down the long nerve fibers that extend from the sensory
cell bodies to the skin and cause the characteristic blisters
of shingles .
Treatment
The severity and duration of an attack of shingles can be
significantly reduced by immediate treatment with antiviral
drugs, which include acyclovir, valcyclovir, or
famcyclovir.
Antiviral drugs may also help stave off the painful
after-effects of shingles known as postherpetic neuralgia.
Other treatments for postherpetic neuralgia include steroids,
antidepressants, anticonvulsants, and topical agents.
Prognosis
For most people, the lesions heal, the pain subsides within
3 to 5 weeks, and the blisters leave no scars. However,
shingles is a serious threat in immunosuppressed individuals —
for example, those with HIV infection or who are receiving
cancer treatments that can weaken their immune systems.
People who receive organ transplants are also vulnerable to
shingles because they are given drugs that suppress the immune
system.
Research
Adenosine monophosphate (AMP), a compound that occurs
naturally in the body, has been found to be effective against
shingles outbreaks. In one double-blind trial, people with an
outbreak of shingles were given injections of either 100 mg of
AMP or placebo three times a week for four weeks.
Compared with the placebo, AMP promoted faster healing and
reduced the duration of pain of the shingles. In addition, AMP
appeared to prevent the development of postherpetic
neuralgia.
Reference for Shingles Article
Bernstein JE, Korman NJ, Bickers DR, et al.
Topical capsaicin treatment of chronic postherpetic neuralgia.
J Am Acad Dermatol 1989;21:265–70.
Sklar SH, Blue WT, Alexander EJ, et al.
Herpes zoster. The treatment and prevention of neuralgia with
adenosine monophosphate. JAMA 1985;253:1427–30.
Sklar SH, Wigand JS. Herpes zoster. Br J
Dermatol 1981;104:351–2.
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