Herpes zoster virus is VZV that reactivates later
in life to cause shingles.
VACCINE
live attentuaed varicella virus
TRANSMISSION
from person to person by directly
touching the blisters, saliva or mucus
The virus can also be
transmitted through the air
by coughing and sneezing.
STAGES
successive and can be seen together
PATHOGENESIS
SYMPTOMS
pain/ burning
fluid-filled blisters
red rash
sensitivity to touch
itching
unilateral,
doesn't cross
midline usually
RISK FACTORS
age >50 y.o.
diseases that weaken
immune system, e.g.
cancer, aids
undergoing radio
or chemotherapy
certain
medication use,
e.g. prednisone
COMPLICATIONS
vision loss
skin infections
neurological problems
POSTHERPETIC
NEURALGIA
severe pain that continues for more than 1 to 3
months in the same place that the shingles occurred,
even after the rash goes away. 8-70% of cases
TREATMENT
PAIN
MANAGEMENT
narcotics, e.g. codeine
numbing agents, such as lidocaine, delivered via
a cream, gel, spray or skin patch
capsaicin topical patch (qutenza)
an injection including corticosteroids and
local anesthetics
PREVENTION
SINGLES VACCINE: for people aged 60 or over, or 50
or over for people living with someone who is
immunocompromised.
ANTIVIIRALS: -
acyclovir, valacyclovir,
and famciclovir
ANATOMY OF LEILA'S
FOREARM
POSTERIOR
COMPARTMENT
ANTERIOR COMPARTMENT
BLOOD SUPPLY
NERVE SUPPLY
DIAGNOSIS
History of pain + telltale rash
and blisters
LABORATORY
Tzanck smear: showing
multinucleated giant cells
FAMA:
Fluorescent
antibody to
membrane
antigen
tissue scrapping/
culture of blisters
OTHER PNS
INFECTIONS
BACTERIA
LEPROSY
Also known as Hansen's disease is a curable infection
caused by slow-growing bacteria called Mycobacterium
leprae. It can affect the nerves, skin, eyes, and lining of
the nose (nasal mucosa)
VIRUS
RABIES
A preventable viral disease most often transmitted through the bite of a
rabid animal. The rabies virus infects the central nervous system of
mammals, ultimately causing disease in the brain and death.