Consequences of the infection
The skin of the body is covered with sensitive nerves, which are supposed to ensure the sensation of touch, pain and temperature. Larger areas of skin are supplied by a particular nerve. Each of these areas supplied by a particular nerve is marked with a letter and a number and is called a dermatome.
The spread of the skin changes usually takes place strictly dermatome-separated, i.e. affected skin areas are usually sharply demarcated and end directly at an adjacent dermatome. After a chickenpox illness has healed, some viruses remain inactive in the so-called spinal ganglia. These are accumulations of nerve cells near the spinal column.
The end branches of such spinal nerves each supply a specific dermatome. The viruses often remain in the dorsal root ganglia for decades. Sometimes, especially in old age, the viruses are reactivated and then infect the dermatome. In most cases, a sharply defined belt-shaped area then becomes inflamed, often in the area of the ribcage, but sometimes also in the face or neck. This clinical picture caused by the reactivation of the viruses is called shingles.
Diagnosis
The diagnosis is usually made on the basis of a gaze diagnosis, as the pattern of spread of the skin irritation is characteristic and is based on the body’s own dermatomes.
Treatment
To a lesser extent, shingles can be treated conservatively, i.e. with cooling compresses and appropriate ointments to minimize itching. To a greater extent, however, shingles must be treated consistently with medication. The drug of choice is acyclovir, which can be given systemically as an ointment or tablet.
In the case of severe pain in the skin area, the drug gabapentin can also be used to reduce nerve pain. In this combination, severe courses of the herpes zoster infection can be controlled in many cases. The duration of the treatment varies and depends on the severity of the disease.
Risk factors
Risk factors of a shingles to fall ill are
- Chickenpox experienced at a young age
- Frequent and intensive contact with carriers of the varicella zoster virus
- A weakened immune system: Patients whose immune system is weakened, either by medication or stress, have a significantly higher risk of developing shingles than immunologically balanced patients.
