Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Shingles (also termed herpes zoster or zoster) is a disease caused by reactivation of a previous infection with the herpes zoster virus (also named varicella-zoster virus, VZV, HHV-3, or chickenpox virus) that results in a painful localized skin rash, usually with blisters (fluid-filled sacs) on top of reddish skin. Herpes zoster viruses do not cause the sexually transmitted disease genital herpes. That disease is caused by another virus named
herpes genitalis (also termed herpes simplex virus, type 2 or HSV-2).
The chickenpox virus (varicella-zoster, VZV) may remain in a dormant state in
the body after an individual has chickenpox, usually in the roots of nerves that
control sensation. In about one out of five people previously infected with
chickenpox, the virus "wakes up," or reactivates, often many years or decades
after a childhood chickenpox infection. When the virus is reactivated and causes
shingles, the resulting virus is usually referred to as herpes zoster virus.
Researchers do not know what causes this reactivation. What is known is that
after reactivation the virus travels along a sensory nerve into the skin and
causes shingles. The majority of people who get shingles are over the age of 60;
it infrequently occurs in younger people and children. Investigators estimate
that about 1 million cases of shingles occur per year in the U.S.
The term shingles is derived from the Latin and French words for belt or girdle, reflecting the distribution of the rash in usually a single broad band. This band is only on one side of the body in the large majority of people and represents a dermatome -- the area that a single sensory nerve supplies in the skin. The painful area may occupy part or all of the dermatome (see figure 1 below).
Risk factors for shingles are common, and the majority of people have at least one or more risk factors. For example, anyone who has had the chickenpox infection or chickenpox vaccine (live attenuated virus) may carry the herpes zoster virus that causes shingles. Older people (over 50 years of age), those with cancer,
HIV, or organ transplant, or people
who have a decreased ability to fight off infection due to stress or immune deficiency have a greater chance of getting shingles.
However, the majority of people with shingles or risk factors for shingles are relatively healthy. Most people do not need special tests to be done to see if their immune system is strong and functioning normally.
Picture of shingles in a child with leukemia showing a characteristic band of lesions; SOURCE: CDC
Shingles, or herpes zoster, is a very common painful, blistering viral rash.
Shingles is caused by reactivation of the chickenpoxvirus called varicella
zoster virus (VZV). Shingles occurs in people who have previously been infected
with the chickenpox virus at some point in their lives. Shingles usually occurs
as a unilateral pain, burning, or tingling and blistering rash extending in a
local pattern in the distribution of nerves. Common areas affected by shingles
include the face, abdomen, back, buttocks, and chest. Red, itchy patches form
across these areas and become small blisters that may be similar in appearance
to chickenpox. The rash begins to clear after the blisters break and dry into
scabs within two to three weeks.