Herpes zoster (shingles)

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    Acute viral infection due to the varicella-zoster virus. Chickenpox is the primary infection and herpes zoster the reactivation of the latent virus.

    Clinical features

    • Unilateral neuralgic pain followed by an eruption of vesicles on a erythematous base, that follow the distribution of a nerve pathway.
    • Lesions most commonly occur on the thorax, but herpes zoster may also develop on the face with a risk of ophthalmic complications.
    • Herpes zoster is more common in adults than in children.

    Treatment

    • Similar to that of herpes simplex, with the addition of systematic analgesics: paracetamol PO (see Pain, Chapter 1).
    • Aciclovir PO given within the first 48 hours after the eruption of lesions is only indicated for severe forms: necrotic or extensive lesions or lesion on the face which may spread to the eyes (see HIV infection and AIDS, Chapter 8).