Shingles
Last updated 18 Aug 2020
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Shingles (also known as herpes zoster) results from infection by the varicella zoster virus. This common virus causes chickenpox (also known as varicella), which is characterised by itchy spots on the skin that cover the whole body and usually occurs in childhood or adolescence. After the body fights the initial infection, the varicella zoster virus remains in nerve cells for the rest of a person's life. Because the virus is controlled by immune system cells called T cells, it is generally inactive (latent) and typically causes no health problems. However, in some people, the virus becomes active again (reactivates) and causes shingles. Shingles can occur at any age, although it is rare in childhood and becomes more common after age 50.
Description
Shingles (also known as herpes zoster) results from infection by the varicella zoster virus. This common virus causes chickenpox (also known as varicella), which is characterised by itchy spots on the skin that cover the whole body and usually occurs in childhood or adolescence. After the body fights the initial infection, the varicella zoster virus remains in nerve cells for the rest of a person's life. Because the virus is controlled by immune system cells called T cells, it is generally inactive (latent) and typically causes no health problems. However, in some people, the virus becomes active again (reactivates) and causes shingles. Shingles can occur at any age, although it is rare in childhood and becomes more common after age 50.
Shingles is characterised by a severely painful, itchy, or tingling rash, most commonly on one side of the torso, although it can occur anywhere on the body. Reactivation of the virus usually occurs in a single nerve, leading to the symptoms of shingles in just the region of skin connected to that nerve. When the nerve connected to the eye and the skin surrounding it is affected, the condition is called herpes zoster ophthalmicus. This form of shingles, which accounts for about 20 percent of cases, can cause permanent vision impairment.
Some individuals with shingles feel throbbing or tingling in the affected region shortly before the rash appears. Blisters form in the rash area, break open, and scab over in a few days. Healing usually takes 2 to 4 weeks. Most people have only one episode of shingles, although it can recur in rare cases.
In 5 to 20 percent of people with shingles, severe pain continues in the affected region after healing of the rash, which is known as postherpetic neuralgia (PHN). PHN is the most common complication of shingles. It can also involve severe itchiness or an overactive pain response to things that do not usually cause pain (allodynia), such as a light touch. PHN can last weeks, months, or even years. The likelihood of developing PHN after shingles and its severity increase with age. The pain caused by shingles and PHN can disrupt day-to-day activities and reduce a person's quality of life.
Inheritance patterns
The source lists the following possible inheritance patterns: Pattern unknown. More than one pattern can apply in different cases.
Related genes
Other names
Herpes zoster
Zoster
Related patient information and medicines
Patient information leaflet
Shingles
Shingles is a rash caused by the varicella-zoster virus (the virus that causes chicken pox). After a chicken pox infection, the virus lies dormant in nerve cells and can be re-activated causing shingles. What is shingles. Shingles (also known as herpes zoster) is a blistery rash which is often painful and which develops in one specific area of the.
Patient information leaflet
Immunisation
DTaP/IPV: for pregnant women from 16 weeks of gestation to protect the newborn baby against whooping cough or people travelli... Shingles (Shingrix): for adults aged 70 or 78 years. (Plus catch-up for adults born after 2nd September 1942 who have not previously been immunised if they are under 80 years). Shingles immunisation The shingles vaccine.
Patient information leaflet
Chickenpox in children
Shingles Shingles is caused by the same virus that causes chickenpox and is a very delayed complication of chickenpox. Shingles is an infection of a nerve and the area of skin supplied by the nerve. It causes a rash and pain in a local band-like area along the affected nerve. About 1 in 5 people have shingles at some time in their lives. The.
Patient information leaflet
Left upper quadrant pain
Left upper quadrant (LUQ) pain is pain located in the upper part of the abdomen on your left-hand side. Shingles Shingles can cause pain in the upper left abdomen because it affects the nerves in that area. The pain is usually on one side of the body, under the ribs or around to the back, in a stripe-like pattern. The LUQ is a common place for a.
Patient information leaflet
Chickenpox in adults and teenagers
Chickenp... Shingles is caused by the same virus that causes chickenpox and so is a delayed complication of chickenpox. Anyone who has had chickenpox in the past may develop shingles. Shingles is an infection of a nerve and the area of skin supplied by the nerve. About 1 in 5 people have shingles at some time in their lives. It can occur at any.
Patient information leaflet
Right upper quadrant pain
The right upper quadrant is a section of your tummy (abdomen) on the upper right hand side. In adults, the most common causes of right upper quadrant pain are: Gallstones. Shingles. An infection may develop, called cholecystitis , which causes more persistent RUQ pain along with a ... Shingles Shingles can cause pain in the right upper abdomen.
Further reading and references
- Shingles; MedlinePlus, National Library of Medicine.
- Canadian Pain Society Study Day participants. Safety and effectiveness of the herpes zoster vaccine to prevent postherpetic neuralgia: 2014 Update and consensus statement from the Canadian Pain Society. Pain Res Manag. 2015 Jan-Feb;20(1):46-7. doi: 10.1155/2015/438597.
- Chen N, Li Q, Yang J, Zhou M, Zhou D, He L. Antiviral treatment for preventing postherpetic neuralgia. Cochrane Database Syst Rev. 2014 Feb 6;2014(2):CD006866. doi: 10.1002/14651858.CD006866.pub3.
- Cho JW, Shin DH, Lee KS. Polymorphism of the IL-10 gene is associated with susceptibility to herpes zoster in Korea. J Dermatol Sci. 2007 Mar;45(3):213-5. doi: 10.1016/j.jdermsci.2006.11.004. Epub 2007 Jan 3. No abstract available.
- Crosslin DR, Carrell DS, Burt A, Kim DS, Underwood JG, Hanna DS, Comstock BA, Baldwin E, de Andrade M, Kullo IJ, Tromp G, Kuivaniemi H, Borthwick KM, McCarty CA, Peissig PL, Doheny KF, Pugh E, Kho A, Pacheco J, Hayes MG, Ritchie MD, Verma SS, Armstrong G, Stallings S, Denny JC, Carroll RJ, Crawford DC, Crane PK, Mukherjee S, Bottinger E, Li R, Keating B, Mirel DB, Carlson CS, Harley JB, Larson EB, Jarvik GP. Genetic variation in the HLA region is associated with susceptibility to herpes zoster. Genes Immun. 2015 Jan-Feb;16(1):1-7. doi: 10.1038/gene.2014.51. Epub 2014 Oct 9.
- Gagliardi AM, Andriolo BN, Torloni MR, Soares BG, de Oliveira Gomes J, Andriolo RB, Canteiro Cruz E. Vaccines for preventing herpes zoster in older adults. Cochrane Database Syst Rev. 2019 Nov 7;2019(11):CD008858. doi: 10.1002/14651858.CD008858.pub4.
- Gatti A, Pica F, Boccia MT, De Antoni F, Sabato AF, Volpi A. No evidence of family history as a risk factor for herpes zoster in patients with post-herpetic neuralgia. J Med Virol. 2010 May;82(6):1007-11. doi: 10.1002/jmv.21748.
- Haanpaa M, Nurmikko T, Hurme M. Polymorphism of the IL-10 gene is associated with susceptibility to herpes zoster. Scand J Infect Dis. 2002;34(2):112-4. doi: 10.1080/00365540110077218.
- Hernandez PO, Javed S, Mendoza N, Lapolla W, Hicks LD, Tyring SK. Family history and herpes zoster risk in the era of shingles vaccination. J Clin Virol. 2011 Dec;52(4):344-8. doi: 10.1016/j.jcv.2011.08.014. Epub 2011 Sep 15.
- Kawai K, Yawn BP. Risk Factors for Herpes Zoster: A Systematic Review and Meta-analysis. Mayo Clin Proc. 2017 Dec;92(12):1806-1821. doi: 10.1016/j.mayocp.2017.10.009.
- Meysman P, De Neuter N, Bartholomeus E, Elias G, Van den Bergh J, Emonds MP, Haasnoot GW, Heynderickx S, Wens J, Michels NR, Lambert J, Lion E, Claas FHJ, Goossens H, Smits E, Van Damme P, Van Tendeloo V, Beutels P, Suls A, Mortier G, Laukens K, Ogunjimi B. Increased herpes zoster risk associated with poor HLA-A immediate early 62 protein (IE62) affinity. Immunogenetics. 2018 Jun;70(6):363-372. doi: 10.1007/s00251-017-1047-x. Epub 2017 Dec 1.
- Meysman P, Ogunjimi B, Naulaerts S, Beutels P, Van Tendeloo V, Laukens K. Varicella-zoster virus-derived major histocompatibility complex class I-restricted peptide affinity is a determining factor in the HLA risk profile for the development of postherpetic neuralgia. J Virol. 2015 Jan 15;89(2):962-9. doi: 10.1128/JVI.02500-14. Epub 2014 Oct 29.
- Ogunjimi B, Zhang SY, Sorensen KB, Skipper KA, Carter-Timofte M, Kerner G, Luecke S, Prabakaran T, Cai Y, Meester J, Bartholomeus E, Bolar NA, Vandeweyer G, Claes C, Sillis Y, Lorenzo L, Fiorenza RA, Boucherit S, Dielman C, Heynderickx S, Elias G, Kurotova A, Auwera AV, Verstraete L, Lagae L, Verhelst H, Jansen A, Ramet J, Suls A, Smits E, Ceulemans B, Van Laer L, Plat Wilson G, Kreth J, Picard C, Von Bernuth H, Fluss J, Chabrier S, Abel L, Mortier G, Fribourg S, Mikkelsen JG, Casanova JL, Paludan SR, Mogensen TH. Inborn errors in RNA polymerase III underlie severe varicella zoster virus infections. J Clin Invest. 2017 Sep 1;127(9):3543-3556. doi: 10.1172/JCI92280. Epub 2017 Aug 7.
- Siegel AM, Heimall J, Freeman AF, Hsu AP, Brittain E, Brenchley JM, Douek DC, Fahle GH, Cohen JI, Holland SM, Milner JD. A critical role for STAT3 transcription factor signaling in the development and maintenance of human T cell memory. Immunity. 2011 Nov 23;35(5):806-18. doi: 10.1016/j.immuni.2011.09.016.
- Toubiana J, Okada S, Hiller J, Oleastro M, Lagos Gomez M, Aldave Becerra JC, Ouachee-Chardin M, Fouyssac F, Girisha KM, Etzioni A, Van Montfrans J, Camcioglu Y, Kerns LA, Belohradsky B, Blanche S, Bousfiha A, Rodriguez-Gallego C, Meyts I, Kisand K, Reichenbach J, Renner ED, Rosenzweig S, Grimbacher B, van de Veerdonk FL, Traidl-Hoffmann C, Picard C, Marodi L, Morio T, Kobayashi M, Lilic D, Milner JD, Holland S, Casanova JL, Puel A; International STAT1 Gain-of-Function Study Group. Heterozygous STAT1 gain-of-function mutations underlie an unexpectedly broad clinical phenotype. Blood. 2016 Jun 23;127(25):3154-64. doi: 10.1182/blood-2015-11-679902. Epub 2016 Apr 25.
- Warren-Gash C, Forbes H, Breuer J. Varicella and herpes zoster vaccine development: lessons learned. Expert Rev Vaccines. 2017 Dec;16(12):1191-1201. doi: 10.1080/14760584.2017.1394843. Epub 2017 Oct 30.
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