Korea’s No. 1 Senior Image Making Expert, Kim Yi-ryeong
A disease that can affect anyone, young or old
I have often come across cases of herpes zoster, which causes severe pain and even hospitalization. It is a disease that can appear to anyone, regardless of age or gender, and I thought that herpes zoster, which can be easily exposed when immunity is lowered, is no exception to me. Three years ago, I had been vaccinated once morest shingles. Should I say goodbye all night? Our body sends signals at any time. A few days ago, I felt pain as if stabbing the upper thigh above the left knee with an awl. I suffer from severe pain intermittently for 3 days with no known cause, what should I do? I was having a difficult time because I mightn’t control it. Should I go to a neurologist? Should I go to a dermatologist? Fortunately, the symptoms disappeared like a lie following 3 or 4 days, so I am now living in a calm state. why? Did your body become aware of such symptoms? What if the same symptoms come once more? I thought I had to deal with it quickly, so I decided to learn all the questions regarding shingles.
The location of the onset of herpes zoster is a disease of the skin and nervous system, and it is a disease that occurs when the varicella-zoster virus, which was dormant in the ganglion of the human body, is reactivated.
The shingles vaccine is a drug that prevents shingles by making antibodies once morest the shingles virus. It is a weakened live herpes zoster virus that prevents shingles by making antibodies in the body following inoculation.
It should not be administered if the immune function is deficient, and should not be used for the treatment of herpes zoster.
The shingles vaccine is recommended for adults over 60 years of age and is injected subcutaneously in the upper arm.
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Herpes zoster is a disease that usually occurs in the elderly and requires attention because it can leave a complication called postherpetic neuralgia. Postherpetic neuralgia is best prevented because once it occurs, it is not treated well and has a huge adverse effect on the patient’s quality of life. It is said that the controversy is still not settled as to whether the use of antiviral drugs, analgesics, and steroids, which are various treatments for herpes zoster, prevents postherpetic neuralgia. So far, the surest way to prevent postherpetic neuralgia is to get a shingles vaccine. If you get chickenpox, you will develop immunity as if you had been vaccinated, but if the immunity decreases over a long period of time, the virus will cause the disease once more. Therefore, vaccination is to enhance immunity once morest the virus that causes chickenpox. In principle, it is the same as the chickenpox vaccination for children. The difference is that the shingles vaccine is much higher.
The results of clinical trials conducted abroad (published in New England Journal Medicine in 2005) provide answers to important questions regarding shingles vaccination.
How effective is the shingles vaccine?
According to the results of clinical trials, vaccination was not 100% effective. The effect of reducing the incidence of herpes zoster by 50% and the occurrence of postherpetic neuralgia by regarding 60% was confirmed. This means that even if you have been vaccinated once morest shingles, you can still get shingles. However, it is said that the vaccinated people suffered much more mildly even if they got shingles, and the intensity of postherpetic neuralgia was much less.
For whom is the shingles vaccine most effective?
According to data analyzing the clinical trial results according to age, it was found that vaccination at a young age had a greater preventive effect. In other words, the prevention effect was regarding 60% in the 60s, but it decreased to 40% in the 70s and 20% in the 80s. Unfortunately, it has been shown that prevention is less effective in the age group that suffers the most from shingles. Considering the high cost of vaccination, it is desirable to vaccinate people in their 60s, who have the greatest cost-effectiveness. On the other hand, vaccination is not strongly recommended in the age group under the age of 50 because the frequency of postherpetic neuralgia following suffering from herpes zoster is low.
How long will the shingles prevention effect last?
Although it is not possible to give a definitive answer, according to the results of clinical trials, the effect is said to be certain for at least 3 years. In addition, according to the results of the preclinical test conducted prior to the clinical trial, since immunity was maintained for up to 5 years following vaccination, it can be expected that there will be a preventive effect for at least that period.
Why do I get shingles?
The chickenpox-herpes zoster virus, which had been dormant in the sensory ganglia of a person who had previously had chickenpox or had been vaccinated once morest chickenpox, is reactivated due to a change in the cellular immune system and travels down the nerves to infect the skin. Factors that induce virus reactivation include old age, trauma, malignant tumors, and leukemia.
What are the symptoms of shingles?
On average, 4 to 5 days before the appearance of the skin lesion, pain, tenderness, and paresthesia occur along the dermatome, hypersensitivity reactions to mild stimuli may occur, and headache, malaise, and fever may accompany very few cases. Skin rashes are distributed in bands along the affected nerves, appear as erythematous papules and spots, and blisters are formed within 12 to 24 hours. The skin lesion and the patient’s pain level are proportional, and older patients complain of more severe pain. Rarely, patients complain of pain, but skin lesions may not occur. The site of occurrence frequently occurs in the chest, face, and waist, and it is said that most occur unilaterally and do not cross the midline.
Shingles causes pain, but why?
Herpes zoster virus invades nerves and causes pain. In addition to pain, abnormal sensations appear. Even following the skin lesion of herpes zoster is healed, the nerve cells are destroyed by the virus, leaving a wound on the nerve, leaving neuralgia following herpes zoster. Although lesions appear on the skin externally, internally, the nerves are stimulated and the pain can be severe, like being stabbed with a knife. These pain symptoms usually appear more severe in proportion to the age.
How long and how to treat herpes zoster?
The treatment of shingles requires taking antiviral drugs or injections for 7 days, and pain relievers are used together to control the pain. If a bacterial infection is suspected in the shingles area, antibiotics can be used, and if the inflammation is severe, anti-inflammatory drugs or steroids can be used together. In the case of the skin, following the blisters are popped and disinfected cleanly, a dressing preparation that can absorb the juice and help the skin regenerate is used. If pain cannot be controlled with painkillers alone, pars or ointments with analgesic effect are used, LEDs are irradiated, and nerve block is sometimes performed. If hospitalized and treated, antiviral injections can be used, pain control is easier, and you can get away from overwork or stress that causes it. say that it is not
How can I avoid getting shingles?
Prevention of herpes zoster can be achieved through the recently developed shingles vaccine. It is said that the shingles vaccine showed prevention through an increase in beneficial immunity once morest the shingles virus in 70% of patients vaccinated with a live, attenuated virus. In addition, to avoid getting shingles, you should avoid situations that can cause shingles. If you are under a lot of care or stress, if you do excessive travel or exercise, if you are physically and mentally difficult, such as if you are working excessively or not getting enough sleep, you should avoid this situation as the virus reactivates due to reduced immunity. In patients who have had shingles once, recurrence is very rare (less than 5%), but if a recurrence occurs, it is necessary to re-examine the entire body, and the effectiveness of shingles vaccination in recurrent patients is unknown.
How should I treat the pain that remains following the skin lesions of herpes zoster are gone?
Postherpetic neuralgia is the most painful complication of herpes zoster complications following the skin lesion disappears and the pain continues even following treatment. Additional accompanying sleep disturbance, fatigue due to chronic pain, depression, etc. may be accompanied, so it is said that pain should be controlled with active analgesic use. If necessary, invasive nerve block may be attempted. It is known that regarding 50% of patients show improvement within 3 months and 70% of patients within 1 year.
It is said that shingles can be mistaken for another disease. How can you easily tell them apart?
It is said that herpes zoster is easily misunderstood as a different disease depending on the site of occurrence when the prodromal symptoms occur without the lesion being revealed. In the case of shingles that occurs on the face, it is easy to think of it as a headache, when it occurs on the side, it is easily mistaken for urolithiasis or gallstones, and when it invades the extremities, it is easy to be mistaken for body aches, muscle pain or disc. In such a case, it is not easy to diagnose herpes zoster, and if symptoms occur locally in a specific ganglion on one side of the body, or when the skin is touched, it is accompanied by a painful sensation, or if the symptoms occur recently, following fatigue or overexertion, you should suspect shingles and be careful. should be closely observed. If a skin lesion appears, a diagnosis may be possible only with the clinical picture.
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Is shingles contagious?
It is said that the varicella zoster virus can be transmitted by contact with the ooze following the blisters of a shingles patient have burst, and in rare cases, it can also be transmitted through the airborne route. When a person who has not had chickenpox becomes infected with the varicella-zoster virus, it is said to develop in the form of chickenpox. After getting chickenpox, the virus remains dormant in the ganglion and reactivates when immunity is weakened, causing shingles. Therefore, if someone who has never had chickenpox has come into contact with someone who has shingles, they may consider getting the chickenpox vaccine to prevent it.
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