A middle aged person gives a history of pain, tingling and dysaethesia along the course of nerve with appearance of the characteristic eruption (vesicles, papules, bullons lesions) throughout the dermatome. This condition is SHINGLES or HERPES ZOSTER.
Vericella zoster virus is responsible for this condition. The dorsal root ganglia of certain cranial nerves pick up the original infection in an attack of chickenpox many years earlier. The viruses of chickenpox and herpes zoster are identical.
These two conditions come from the same virus, called varicella zoster.
Chickenpox causes itchy blisters that might start on back, chest, and face and spread to the rest of the body. Shingles is a rash with shooting pain. It usually shows up on one side of body.
The rash turns into red, fluid-filled blisters. They usually dry out and crust over within 7 to 10 days.
The early signs of shingles include:
- Fever, chills, and headache
- Raised dots on your skin and redness in that area
- Stabbing or shooting pain
- Tingling in or under your skin
- Upset stomach
some time pain is still remain while rash is gone, this is called postherpetic neuralgia.
When the varicella zoster virus gets into the body, the first problem it causes is chickenpox.
After chickenpox runs its course, the virus moves into the nerve tissues near the spinal cord and brain, where it stays.
We don’t know why, but sometimes the virus “wakes up” and travels along nerve fibers to your skin. That’s when it lands its second punch: shingles, also called herpes zoster.
A weakened immune system might wake up the virus. After you’ve had chickenpox, you’re more likely to get shingles if you:
- Are 50 or older
- Are under a lot of stress
- Have cancer, HIV, or another disease that lowers your body’s defenses
- Have had a serious physical injury
- Take long-term steroids or other medicines that can weaken our immune system
The disease presents three sets of symptoms: burning or the premonitory pain that starts much before the appearance of vesicles; actual eruptions- vesicles; and later pustules follow, without severe itching.
The whole condition is highly infections and care needs to be taken to segregate the patient, his clothes, bedsheets, towel, etc. personal items like handkerchief, comb, etc should be frequently disinfected. When there is itching, scratching with nails or any pointed article should be avoided; a clean, soft cloth should be used to slide it over the skin.
Ranunculus bulbosus- Herpes with vesicular and pustular eruptions. Bluish vesicles which burn and itch intensely, worse on contact or touch. Pains are stitching, stabbing, shooting, extorting tears, with shuddering. Patient is restless, cannot stay in one position. Burning in small spots from a sedentary lifestyle.
Rhus toxicodendron- Neuralgic pains along the dermatome that corresponds to the pathogenesis of herpes zoster. Severe burning and neuralgic pains after herpes. Herpetic eruptions altetrnate with dysentery and pain in the chest.
Tarantula cubensis affects the cellular tissue and is useful in septic conditions. Although the incubation is slow, the condition progresses rapidly with alarming proportion . atrocious burning and stinging pains with shingles. Purple discolouration of lesions. Also useful in carbuncles.
Arsenicum album skin is dry, rough and scaly, looking like parchment herpetic eruptions with vesicles which burn violently . burning pains are characteristic of arsenicum album and are better by warm application.