Shingles Skin Deep or Deeper ?..



Shingles:  Skin deep or deeper?

Shingles is a common affliction of the elderly and immune compromised individuals. Most individuals are already immune to the chicken pox or have been affected earlier in life. However, when one’s immunity drops, the chicken pox virus or Varicella Zoster Virus can become reactivated and can spread along different nerves and emerge as a blister like rash affecting an area of the skin supplied by that nerve or a dermatome. Often times the trunk is affected in a band like distribution or a third of the face on one side is affected and can progress over a week or two and then change to dry scabs followed by pigment changes and rarely scarring. Typically as the nerve is inflamed there is loss of function of that nerve with numbness and tingling and often times can progress to a severe burning sensation known as PHN or Post Herpetic Neuralgia, a condition that is difficult to treat and often times very long lasting.

A shingles vaccine was developed to help decrease the risk of shingles in those above the age of 60. Contrary to the general belief the vaccine can still be given to those who have had shingles to prevent further future attacks.

Recent research has shown that the varicella virus may be involved in many more conditions than physicians were earlier aware of. Most recently 74% of biopsies of Temporal Arteritis ( Giant Cell Arteritis or GCA)  cases, a worrisome condition that causes headaches in the elderly and can lead to sudden blindness or strokes due to inflammation of the blood vessels supplying the eyes or brain, were shown to harbor the Varicella Zoster virus when compared to normal biopsies (vs 8%). This would suggest that the VZ virus triggers an immune response and in turn causes inflammation in the blood vessels possibly leading to this condition. This provides treatment opportunities with antivirals such as valcyclovir or acyclovir, in addition to the previously prescribed long term steroids such as prednisone.

Tip: If you are at a risk for chronic disease conditions or over 60 years of age, consider taking the shingles vaccine today..