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Postherpetic Neuralgia (Pain Following Shingles)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Postherpetic neuralgia is a neuropathic pain and is the most common complication of shingles, which is a reactivation of the chickenpox, or varicella, virus. The virus causes a painful rash and blistered skin lesions that typically follow along the course of a peripheral nerve, and is characteristic of shingles (herpes zoster). Most times when the shingles or blisters fade away, so does the pain. In some cases, however, constant, or sharp, burning recurring pain lasts long after the rash and blisters clear up.1 This is known as postherpetic neuralgia and is defined as pain that persists one to three months following the disappearance of the herpes zoster rash. About 20% of people who get shingles, particularly in patients over 60, go on to develop postherpetic neuralgia.
Viral Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
In younger immunocompetent patients, the total duration of the disease is generally 2–3 weeks, while in elderly patients, it can take greater than 6 weeks for lesions to heal. Pain can last after skin lesions resolve and is called postherpetic neuralgia (PHN); the duration and severity of PHN are variable and often age-dependent. Treatments for postherpetic neuralgia are topical therapy (e.g., lidocaine, capsaicin), tricyclic antidepressants, gabapentin and pregabalin, venlafaxine, and oral analgesics, including opiates.
Dermatoses affecting the genital area
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
For postherpetic neuralgia: carbamazepine 100 mg, one or two times per day; maximum dose: 1.6 g daily.
Dermatomal rash after Shingrix vaccination: cause or coincidence?
Published in Baylor University Medical Center Proceedings, 2022
Nitish Mittal, Nikita Dhir, Neha Mittal
Herpes zoster (Shingles) is a dermatomal rash caused by reactivation of the varicella zoster virus (VZV). VZV usually occurs in childhood, presenting as chickenpox, and remains dormant in the dorsal root ganglia.1 It is often reactivated later in life from stress, aging, or immunodeficiency. Zoster presents as a maculopapular rash that can evolve into vesicular lesions with unilateral dermatomal distribution. It can be further complicated by postherpetic neuralgia or herpes zoster encephalitis.2 The Advisory Committee on Immunization Practices currently recommends adjuvanted recombinant Shingrix vaccines in two doses for all adults over 50 to reduce the incidence of zoster and/or postherpetic neuralgia.3 While Zostavax was a live vaccine with limited efficacy in the older age group, Shingrix is an adjuvanted recombinant zoster vaccine that is widely sought due to its strong efficacy with a sustained antibody response.3
Association between lateral epicondylitis and the risk of herpes zoster development
Published in Postgraduate Medicine, 2021
Chao-Yu Hsu, Der-Shin Ke, Cheng-Li Lin, Chia-Hung Kao
Herpes zoster (HZ) is a viral infection characterized by painful vesicular rashes with a dermatomal distribution; its occurrence is due to the reactivation of the varicella-zoster virus (VZV). Taiwan Centers for Disease Control has provided free varicella vaccination for children over 1-year old since 1 January 1993. HZ vaccine was introduced to Taiwan in 2013; however, it is self-payment. A recent study from Germany that analyzed self-reported disease data revealed that 11% of participants reported at least one HZ episode in their lifetime. [9] Sauboin et al. determined that the incidence of HZ before varicella vaccination was 3.96 per 1000 person-years in the general population. [10] A systemic review study on the incidence of HZ determined that the incidence of HZ in all ages was between 2.1 and 5.5 per 1000 person-years. [11] Postherpetic neuralgia is a painful complication, and subsequent postherpetic neuralgia may occur for months to years after the resolution of an acute phase.
Pox Parties for Grannies? Chickenpox, Exogenous Boosting, and Harmful Injustices
Published in The American Journal of Bioethics, 2020
Heidi Malm, Mark Christopher Navin
The varicella zoster virus (VZV) is responsible for both varicella, commonly known as chickenpox, and herpes zoster (HZ), commonly known as shingles. This virus is transmitted primarily through direct contact with virus from chickenpox sores or from droplets exhaled by infected persons (Heininger and Seward 2006). After people recover from chickenpox, the varicella virus remains inactive in their nerve cells. If it is reactivated, it presents as herpes zoster—shingles—which often manifests with highly painful rashes and is sometimes accompanied by post-herpetic neuralgia, that is, significant pain that can last months or even years after the resolution of the herpes zoster rash (Kost and Straus 1996). The incidence of herpes zoster increases with age (Insinga et al. 2005), as does the likelihood of developing post-herpetic neuralgia (Oxman et al. 2005).