Shingles (Herpes Zoster): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye) rash with formation of vesicles (zoster vesicles; also possible without efflorescence) in the affected dermatome/skin area, … Read more

Shingles (Herpes Zoster): Test and Diagnosis

The diagnosis is usually made clinically. 2nd order laboratory parameters – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification. Direct virus detection using PCR (polymerase chain reaction) from vesicle contents, skin biopsies, cerebrospinal fluid* , or blood – for detection of varicella zoster virus infection [sensitivity and specificity … Read more

Polymorphous Light Dermatosis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin [patchy erythema (areal redness of skin), followed by: bullae (blisters), papules (vesicles), papulo-vesicles (mixture of papule and vesicle (vesicle)), plaques] Predilection sites (typical sites for the appearance of … Read more

Shingles (Herpes Zoster): Drug Therapy

Therapeutic targets Shortening the symptomatic phase Avoidance of complications Therapy recommendations Antiviral therapy: as soon as possible: virostasis (antivirals/drugs that inhibit viral replication)Note: Antiviral therapy within 72 hours of vesicle breakdown also reduces the risk of postzoster neuralgia.First-line therapy: Patients <50 years + limited findings on trunk and extremities: Antivirals (aciclovir, brivudine, valaciclovir, and famciclovir), … Read more

Shingles (Herpes Zoster): Diagnostic Tests

Diagnosis is usually made on the basis of history and physical examination. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnosis in case of complications. Computed tomography of the skull (cranial CT, cranial CT or cCT) – if meningoencephalitis … Read more

Polymorphous Light Dermatosis: Drug Therapy

Therapeutic target Alleviation of symptoms Therapy recommendations Beta-carotene Nicotinamide and folic acid Corticosteroids; azathioprine in extreme individual cases. Antihistamines can relieve the itching See also under “Further therapy“. All agents have in common a relatively limited efficacy. In experimental studies, efficacy has been demonstrated for E. coli extract. Supplements (dietary supplements; vital substances) Appropriate dietary … Read more

Shingles (Herpes Zoster): Prevention

As of March 2018, an adjuvanted subunit total vaccine (containing glycoprotein E of the pathogen) has been approved for the prevention of herpes zoster (HZ) and postherpetic neuralgia (PHN) in persons 50 years of age and older. This has a high protective effect even in older age groups and, in addition to good safety, has … Read more

Shingles (Herpes Zoster): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate herpes zoster (shingles): Prodromal stage (early phase of disease in which nonspecific symptoms occur; about 5 days): First, nonspecific general symptoms (fatigue, impaired performance, fever, and aching limbs) occur. Then local pruritus (itching) and paresthesias (sensory disturbances). Then appearance of typical zoster vesicles (herpetiform vesicles; centrally forked, usually … Read more

Polymorphous Light Dermatosis: Prevention

Limiting sun exposure contributes to the prevention of polymorphous light dermatosis. Prophylaxis is of significant importance. By becoming accustomed to light by means of, for example, phototherapy to general light protection measures (sunscreens with a high sun protection factor (UV-A and UV-B protection), the wearing of caps/hats, etc.), the affected person can prevent or reduce … Read more