Pathogenesis (development of disease)
Herpes zoster is a reactivation of the varicella zoster virus (synonyms: varicella zoster virus (VZV) – also spelled varicella zoster virus and referred to as human herpes virus-3), which has survived inconspicuously for many years in the area of the spinal and/or cranial nerve ganglia. Due to a weakened immune system, endogenous reactivation then occurs with the familiar symptoms.
Etiology (Causes)
Biographic causes (= increased risk of zoster).
- Age – older age: The disease occurs predominantly between the ages of 60 and 70. By age 85, approximately 50% of the population has experienced at least one episode of herpes zoster.
Behavioral causes (= increased risk of zoster).
- Consumption of stimulants
- Alcohol
- Tobacco (smoking, passive smoking)
- Overweight (BMI ≥ 25; obesity).
Disease-related causes (= increased risk of zoster: per se or therapy-related).
- Immunodeficiency wg.
- Transplants
- Malignant hematologic diseases (malignant diseases of the blood-forming organs) such as Hodgkin’s lymphoma, leukemia; plasmacytoma (multiple myeloma); HIV/AIDS.
- Bronchial asthma, chronic (10%).
- Atopic dermatitis (neurodermatitis)
- Chronic obstructive pulmonary disease (COPD) (30%).
- Depression (10%)
- Diabetes mellitus, type 1 (27%)
- Lupus erythematosus (autoimmune disease) (0.3%)
- Psoriasis (psoriasis), severe
- Rheumatoid arthritis (chronic inflammatory multisystem disease, usually manifested in the form of synovitis (inflammation of the synovial membrane)) (46%).
- Tumor diseases
- Celiac disease
Medication
- Chemotherapy
- Immunosuppressive therapy
- Statin therapy, dose-dependent (increased by 13% (odds ratio [OR]: 1.13; 95% confidence interval between 1.11 and 1.15))
- Steroid therapy (corticosteroids/cortisol; dexamethasone).