I. Shingles also known as herpes zoster or zona is defined as a viral disease with condition of a painful, blistering skin rash on one side of the body of that can continue to be painful even after the
rash have long
disappeared(1), as a result of varicella-zoster viral causes of a nerve and skin inflammation.
II. Symptoms
1. Headache
There is a report of a 60-year-old man presented after burning the roof
of his mouth on hot
soup five days earlier. The burned sensation resolved after one day;
however, a couple of days later, he noticed tingling on the right side
of the hard palate that progressed to a scalded sensation. This was
accompanied by tenderness along the right temporal area and discomfort
below the right ear. He denied a history of oral lesions. Doctors in
the Mayo Clinic, the presence of multiple vesicles that vary
in size and are confined to the right side of the hard palate (i.e.,
cranial nerve V2 distribution) accompanied by neuralgia and erythema in
ipsilateral cutaneous portions of the right trigeminal nerve suggests
herpes zoster over oral herpes simplex virus (HSV) infection(2).
2. Other symptoms
Dr. Goh CL, and Dr. Khoo L. at the Institute of Dermatology, National
Skin Center, in a retrospective study of the epidemiology and morbidity
of herpes zoster and the risk factors for herpes zoster morbidity in Singapore, suggested that The common presenting symptoms were pain (90%), feelings of helplessness and depression (20%), and flu-like symptoms
(12%). The commonest prodromes were pain (41%), itching (27%), and
paresthesia (12%). Pain was
experienced by almost all (95%) patients during the course of their
disease. It tended to be more severe in older patients. Burning (26%),
stabbing (15%), and shooting (15%) pain were the most common types
experienced. Post-herpetic neuralgia was significantly more common in
older patients. The prevalence of post-herpetic neuralgia decreased over
time in all age groups. A higher proportion of older patients (more
than 50 years of age) (20%) suffered from post-herpetic neuralgia
compared with younger patients (less than 30 years of age) (7%) (not
significant). Patients in all age groups considered acute pain (46%) and
persistent pain (25%) to be their most unbearable symptoms during the course of herpes zoster. The most significant problems caused by herpes zoster
pain were insomnia (25%), misery (feeling helpless and depressed)
(20%), limitation of movement (9%), and inability to continue work (8%).(3)
3. Not all patients with herpes zoster adjacent to the eye will develop
ocular involvement, but in those that do, there can be a wide variety of
manifestations
a. Eyelid with Rash and vesicles in acute case and Scarring, loss of lashes in chronic case
b. Conjunctiva with Conjunctivitis in acute case
c. Cornea with Corneal ulcers in acute case and Corneal inflammation and scarring, loss of corneal sensation in chronic case.
d. Retina with Retinitis in acute case and Cystoid macular edema (swelling of the central retina) in chronic case
e. Etc.(4)
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/16936604
(2) http://www.aafp.org/afp/2008/0501/p1307.html
(3) http://www.ncbi.nlm.nih.gov/pubmed/9352407
(4) http://www.uveitissociety.org/pages/diseases/hzo.pdf
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