Tuesday, July 01, 2008
Shingles
Shingles is a common and often painful problem that can result in serious injury if not treated promptly.
The offending agent in shingles, the varicella-zoster virus, is acquired with chickenpox. The virus remains dormant in an area of the nervous system called the dorsal root ganglion. It becomes reactivated with illness, age, or suppression of the immune system.
Most adults affected by shingles are over age 60. A weakened immune system either from medical treatments, HIV/AIDS, or cancer will predispose to shingles.
Shingles first becomes apparent with the onset of burning or tingling, followed by the appearance of a rash. The rash consists of fluid-filled blisters along the path of the nerve where it has been residing. It typically appears on one side of the trunk or waistline. The rash will then begin to crust over.
The underlying nerve becomes inflamed and very painful, leading to a condition called herpetic neuralgia. In approximately 20 percent of patients, the pain may linger long after the rash has gone, at which time it is called post-herpetic neuralgia. This nerve pain can last for months or years and varies in severity.
Immediate treatment includes the use of one of several new medications categorized as anti-viral agents. Anti-inflammatory drugs are helpful. Pain relievers, including narcotics, may be necessary although antidepressant and anticonvulsant drugs often have an analgesic effect without addiction potential. Topical creams containing anesthetics are soothing. Capsaicin cream is an over-the-counter preparation made from chili peppers and dulls pain fibers. The Lidoderm patch can be applied directly over the painful area, allowing the anesthetic to be absorbed over a twelve-hour period.
There is a vaccine for adults over 60 years old who have had chickenpox. The goal is to prevent further outbreaks of shingles or reduce the severity of the episode. The vaccine is not intended for the treatment of an active outbreak of shingles.
If you suspect shingles, contact a physician and begin a recommended treatment promptly to shorten the time you are symptomatic.
Anthony G. Alessi, MD, is Chief of Neurology on the medical staff of The William W. Backus Hospital. He has a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Alessi and all of the Healthy Living columnists at healthliving@wwbh.org.
The offending agent in shingles, the varicella-zoster virus, is acquired with chickenpox. The virus remains dormant in an area of the nervous system called the dorsal root ganglion. It becomes reactivated with illness, age, or suppression of the immune system.
Most adults affected by shingles are over age 60. A weakened immune system either from medical treatments, HIV/AIDS, or cancer will predispose to shingles.
Shingles first becomes apparent with the onset of burning or tingling, followed by the appearance of a rash. The rash consists of fluid-filled blisters along the path of the nerve where it has been residing. It typically appears on one side of the trunk or waistline. The rash will then begin to crust over.
The underlying nerve becomes inflamed and very painful, leading to a condition called herpetic neuralgia. In approximately 20 percent of patients, the pain may linger long after the rash has gone, at which time it is called post-herpetic neuralgia. This nerve pain can last for months or years and varies in severity.
Immediate treatment includes the use of one of several new medications categorized as anti-viral agents. Anti-inflammatory drugs are helpful. Pain relievers, including narcotics, may be necessary although antidepressant and anticonvulsant drugs often have an analgesic effect without addiction potential. Topical creams containing anesthetics are soothing. Capsaicin cream is an over-the-counter preparation made from chili peppers and dulls pain fibers. The Lidoderm patch can be applied directly over the painful area, allowing the anesthetic to be absorbed over a twelve-hour period.
There is a vaccine for adults over 60 years old who have had chickenpox. The goal is to prevent further outbreaks of shingles or reduce the severity of the episode. The vaccine is not intended for the treatment of an active outbreak of shingles.
If you suspect shingles, contact a physician and begin a recommended treatment promptly to shorten the time you are symptomatic.
Anthony G. Alessi, MD, is Chief of Neurology on the medical staff of The William W. Backus Hospital. He has a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Alessi and all of the Healthy Living columnists at healthliving@wwbh.org.
# posted by ----------------- @ 12:18 PM 
