Shingles is a painful skin rash . It is caused by the varicella zoster virus.

Shingles usually appears in a

band, a strip, or a small area on one side of the face or body. It is also called herpes zoster.
Shingles is most common in older adults and people who have weak immune systems because of stress,
injury, certain medicines, or other reasons. Most people who get shingles will get better and will not get it
again.
Shingles occurs when the virus that causes chickenpox starts up again in your body. After you get better
from chickenpox, the virus "sleeps" (is dormant) in your nerve roots. In some people, it stays dormant
forever. In others, the virus "wakes up" when disease, stress, or aging weakens the immune system.
Some medicines may trigger the virus to wake up and cause a shingles rash. It is not clear why this
happens. But after the virus becomes active again, it can only cause shingles, not chickenpox.
Shingles symptoms happen in stages. At first you may have a headache or be sensitive to light. You may
also feel like you have the flu but not have a fever.
Later, you may feel itching, tingling, or pain in a certain area. That's where a band, strip, or small area of
rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then
crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get
a mild rash. And some do not get a rash at all.
It's possible that you could also feel dizzy or weak. Or you could have long-term pain or a rash on your
face, changes in your vision, changes in how well you can think, or a rash that spreads. If you have any of
these problems from shingles, call your doctor right away.
Shingles is treated with medicines. These medicines include antiviral medicines and medicines for pain.

CAUSE :
Shingles is a reactivation of the varicella-zoster virus, a type of herpes virus that causes chickenpox. After
you have had chickenpox, the virus lies inactive in yournerve roots and remains inactive until, in some
people, it flares up again. If the virus becomes active again, you may get a rash that occurs only in the
area of the affected nerve. This rash is called shingles.
Anyone who has had even a mild case of chickenpox can get shingles. This includes children.
Transmission :
Exposure to shingles will not cause you to get shingles. But if you have not had chickenpox and have not
gotten the chickenpox vaccine, you can get chickenpox if you are exposed to shingles. Someone who has
shingles can expose you to the virus if you come into contact with the fluid in the shingles blisters.
If you are having an active outbreak of shingles, you can help prevent the spread of the virus to other
people. Cover any fluid-filled blisters that are on a part of your body that isn't covered with clothes.
Choose a type of dressing that absorbs fluid and protects the sores.

SYMPTOMS :
When the virus that causes chickenpox reactivates, it causes shingles. Earlysymptoms of
shingles include headache, sensitivity to light, and flu-like symptoms without a fever. You may then
feel itching, tingling, or pain where a band, strip, orsmall area of rash may appear several days or
weeks later. A rash can appear anywhere on the body but will be on only one side of the body, the left or
right. The rash will first form blisters, then scab over, and finally clear up over a few weeks. This band of
pain and rash is the clearest sign of shingles.
The rash caused by shingles is more painful than itchy. The nerve roots that supply sensation to
your skin run in pathways on each side of your body. When the virus becomes reactivated, it travels up
the nerve roots to the area of skin supplied by those specific nerve roots. This is why the rash can wrap
around either the left or right side of your body, usually from the middle of your back toward your chest. It
can also appear on your face around one eye. It is possible to have more than one area of rash on your
body.

Prodromal stage (before the rash appears)
Pain, burning, tickling, tingling, and/or numbness occurs in the area around the affected nerves several
days or weeks before a rash appears. The discomfort usually occurs on the chest or back, but it may
occur on the belly, head, face, neck, or one arm or leg.
Flu-like symptoms (usually without a fever), such as chills, stomachache, ordiarrhea, may develop just
before or along with the start of the rash.
Swelling and tenderness of the lymph nodes may occur.
Active stage (rash and blisters appear)
A band, strip, or small area of rash appears. It can appear anywhere on the body but will be on only one
side of the body, the left or right. Blisters will form. Fluid inside the blisters is clear at first but may become
cloudy after 3 to 4 days. A few people won't get a rash, or the rash will be mild.
A rash may occur on the forehead, cheek, nose, and around one eye (herpeszoster ophthalmicus), which
may threaten your sight unless you get prompt treatment.
Pain, described as "piercing needles in the skin," may occur along with the skin rash.
Blisters may break open, ooze, and crust over in about 5 days. The rash heals in about 2 to 4 weeks,
although some scars may remain.
Postherpetic neuralgia (chronic pain stage)
Postherpetic neuralgia (PHN) is the most common complication of shingles. It lasts for at least 30 days
and may continue for months or years. Symptoms are:
o Aching, burning, stabbing pain in the area of the earlier shingles rash.
o Persistent pain that may linger for years.
o Extreme sensitivity to touch.
The pain associated with PHN most commonly affects the forehead or chest. This pain may make it
difficult for the person to eat, sleep, and do daily activities. It may also lead to depression.
Shingles may be confused with other conditions that cause similar symptoms. The rash from shingles
may be mistaken for an infection from herpes simplex virus (HSV), poison oak or ivy, impetigo,
or scabies. The pain from PHN may feel likeappendicitis, a heart attack, ulcers, or migraine headaches.




How It Is Done
For a viral culture, viral antigen test, or PCR test, a clean cotton swab is rubbed against a herpes sore
to collect fluid and cells for examination. Samples may be collected from the vagina, cervix, penis,
urethra, eye, throat, or skin. Doctors usually collect a sample from small sores that are only a few days
old. Viruses are more likely to be found in small newly formed sores.
For an antibody test, the health professional drawing blood will:
Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the
band larger so it is easier to put a needle into the vein.
Clean the needle site with alcohol.
Put the needle into the vein. More than one needle stick may be needed.
Attach a tube to the needle to fill it with blood.
Remove the band from your arm when enough blood is collected.
Put a gauze pad or cotton ball over the needle site as the needle is removed.
Put pressure on the site and then put on a bandage.