The rash consists of small blisters that usually peel off in 7 to 10 days and disappear completely within 2 to 4 weeks.

“Many adult patients who visit pathology offices have questions about the occurrence of shingles, and all have some unpleasant story to tell about the disease,” says Mrs. Lilian Atsali, Pathologist – Infectious Diseases Specialist, Deputy Director of the 3rd Pathology Clinic Metropolitan General and continues:

“Patients may have pain, itching or tingling in the area where the rash will appear several days before it appears, and fever may also be present.”

What is it caused by?

“Herpes zoster is caused by the varicella zoster virus (VZV), the same virus that causes chicken pox. After a person recovers from chickenpox, the virus remains dormant (inactive) in the body, specifically in the nerves (ganglia). This virus can reactivate years later, causing shingles with distribution of the rash to the skin area that has sensory innervation from the nerve in which the virus has been activated.
Patients with shingles can transmit the virus to people who have not been vaccinated against the virus. This is done either by direct contact with the liquid in the bubbles or by breathing aerosol from the bubbles. The unvaccinated patient who has not had chicken pox will develop the disease. It is therefore recommended that patients with shingles always have the blister rash covered until it heals,” the specialist points out.

Complications

“The most common complication of shingles is excruciating pain at the site of the rash that persists after it has cleared for months or even years and leads patients to take multiple medications to cope with it.

There are other serious complications that can occur such as loss of vision in an attack of the trigeminal branch of the eye (rash on the forehead around the eye), while in the context of the viremia that can coexist during the reactivation of the virus we can have pneumonitis, meningoencephalitis or hepatitis less often. Bacterial infections of the ulcers can also occur.

The deterioration of the body’s defense is responsible for the appearance of the rash of herpes zoster. Old age and old age are the first and main cause of a drop in the body’s defenses that concerns the entire population, while we see shingles in younger people who are in stressful conditions. A risk factor is also any disease accompanied by immunosuppression such as for example autoimmune or malignant diseases where patients undergo immunomodulating treatments.

Immunizing children with the varicella vaccine can also lead to reactivation of the virus since it is a live vaccine, however, it is thought that the occurrence of shingles is less common than in those who have had chickenpox and it is also an inactivated virus. Data are still lacking regarding older ages since the varicella vaccine was introduced after 1995.

Fortunately, there is prevention and antiviral treatment for shingles. Drug treatment reduces the duration of the rash and the incidence of postherpetic neuralgia as long as it is given in time. That is why it makes sense to inform our doctor immediately about the appearance of the rash even if we know it is shingles and not to underestimate the severity of the disease, so that we can have timely access to the appropriate treatment” emphasizes Mrs. Atsali .

Vaccines

“In addition to the treatment, we also have two shingles vaccines that can be given even to patients who have had shingles as long as the acute phase has passed,” he informs and adds:

“The first live from inactivated virus (zostavax) concerns the general population of immunocompetent patients in Greece after the age of 50 and is administered subcutaneously or intramuscularly in one (1) dose.

The second genetically recombinant vaccine (shingrix) reimbursed only for patients with specific immunosuppression conditions (marrow transplantation, in patients with solid tumors before or during chemotherapy, in patients with hematologic malignancies and in chronically immunocompromised kidney transplant recipients because the National Immunization Committee recommends the inclusion of inactivated, recombinant vaccine against herpes zoster (RZV) in the first phase in people with immunosuppression and in this case it would be good to ask our treating doctor if we are entitled to the vaccine in case we belong to one of the vulnerable groups because the new vaccine is safe and with excellent effectiveness that lasts for many years.It is given in two doses with an interval of two to six months, but in the case that a patient has to start some immunomodulating treatment, the interval can be shortened to one month.

The news is promising for this disease that causes fear and we expect in the next phase the generalization of the application of the new vaccine to the population” concludes Mrs. Atsali.