About Herpes Zoster (Shingles)
Varicella-zoster virus (VZV) involves a primary VZV infection (chickenpox) which is nearly always symptomatic and consists of wide-spread itchy vesicles. During the primary chickenpox infection, VZV establishes a lifelong infection in sensory ganglia. When immunity to VZV declines, VZV reactivates within the nerve cell, traveling down the neuron to the skin, where it erupts in a dermatomal pattern as herpes zoster, also known as shingles. Shingles is an acute dermatomal infection associated with reactivation of VZV and consists of one-sided pain and a vesicular or bullous eruption limited to a dermatome followed by postherpetic neuralgia. Often there is a prodromal stage of 2-3 weeks of neuritic pain, numbmess, or tingling that precedes the eruption. Then the acute vesiculation lasts 3-5 days followed by crust formation for 2-3 weeks. The subsequent postherpetic neuralgia can last months to years.