infections
Shingles
Symptoms and Complications of Shingles
During the 2 or 3 days before shingles develops, most people have pain, a tingling sensation, or itching in a strip of skin (a dermatome) on one side of the body. Clusters of small, fluid-filled blisters surrounded by a small red area then develop on the strip of skin. Typically, the blisters occur only on the limited area of skin supplied by the infected nerve fibers. Most often, blisters appear on the trunk, usually on only one side. However, a few blisters may also appear elsewhere on the body. Typically, blisters continue to form for about 3 to 5 days. The affected area is usually sensitive to any stimulus, including light touch, and may be very painful. Shingles symptoms are usually less severe in children than in adults. The blisters begin to dry and form a scab about 5 days after they appear. Until scabs appear, the blisters are contagious and contain varicella-zoster virus, which, if spread to susceptible people, can cause chickenpox. Having many blisters outside the affected dermatome or having blisters that persist for more than 2 weeks usually indicates that the immune system is not functioning normally. Rarely, the affected skin becomes infected by bacteria. Scratching the blisters increases this risk. Bacterial infections increase the risk of scarring. If shingles affects the nerve that leads to the eye, the eye may be infected. Eye infection is more common when sores occur on the forehead, near the eye, and especially on the tip of the nose. This infection (called Herpes Zoster Ophthalmicus ) can be serious. Even with treatment, vision may be affected. The nerve that leads to the ear may also be affected. This infection (called Herpes Zoster Oticus , or Ramsay Hunt syndrome) can cause blisters in the ear canal, pain, partial paralysis of the face, Scarring or hyperpigmentation of the skin may occur, but most people recover without lasting effects. A few people, more commonly older adults, continue to have chronic pain in the area (postherpetic neuralgia). Postherpetic Neuralgia develops in about 10% of people who have had shingles. It is more common among older adults. In postherpetic neuralgia, people who have had shingles continue to have pain long after the rash has gone away. The pain occurs in areas of skin supplied by nerves infected with herpes zoster. Postherpetic neuralgia can be very severe and even incapacitating. 