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Herpes Zoster, Shingles and AIDS

Zoster usually presents as a painful unilateral dermatomal eruption. Zoster results from reactivation of varicella-zoster (chickenpox) virus that has been dormant in the

Zoster is usually heralded by dermatomal pain, sometimes accompanied by fever. Within a few days, the skin overlying the dermatome reddens and blisters. A few vesicles are usually grouped on one erythematous base, in contrast to the scattered, single vesicles of chickenpox. Several days later the vesicles become pustular and develop crusts, followed by

Zoster may occur in any dermatome, but the thoracic dermatomes are most often affected. In 90% of immunocompetent patients, pain eventually disappears completely.

The frequency of zoster increases markedly after age 55, but people of any age can be affected.

Less than 5% of immunocompetent patients zoster, shingles, varicella zoster who have one episode of herpes zoster will have another, and the episodes are usually separated by years. HIV-infected patients are more likely to have recurrent herpes zoster infections.

15% of patients with zoster have involvement of the ophthalmic branch of the trigeminal nerve. Hutchinson's sign, a lesion on the tip of the nose, indicates corneal involvement; however, ophthalmic involvement may occur even in the absence of Hutchinson's sign. Treatment with IV acyclovir and topical zoster, shingles, varicella, varicella zoster, varicella zoster virus agents is required to prevent blindness.

Disseminated herpes zoster is present when 20 or more lesions occur outside of the primary contiguous dermatomes. These patients zoster, shingles, varicella zoster are at risk for visceral dissemination.

Symptomatic Therapy for Zoster

Wet dressings or compresses with Burow's solution (Domeboro) will

Acetaminophen, nonsteroidal anti-inflammatory drugs, or analgesics with codeine (Vicodin) may be

Antiviral Therapy for Zoster

An antiviral can hasten the resolution of the rash by several days. Relief of acute pain occurs two to three days after an antiviral