Herpes zoster (shingles)


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).