Shingles Spread, Manifestations, and Medical Remedies
Disseminated shingles is a more severe form of shingles, a viral infection that typically affects one or two dermatomes on the face or chest area. Unlike localized shingles, disseminated shingles can spread across multiple dermatomes and affect a wider area of the body.
This rare but potentially serious condition occurs when the immune system is weakened, making it difficult to contain the varicella-zoster virus (VZV), which also causes chickenpox. Factors that can weaken the immune system and increase the risk of disseminated shingles include older age, HIV, cancer, cancer treatments, excess sun exposure, organ transplant drugs, stress, and certain chronic diseases.
Disseminated shingles affects around 2% of the general population, but the risk increases significantly in immunocompromised individuals, with around 15% to 30% of cases affecting those with compromised immune systems.
The most common complication of disseminated shingles is postherpetic neuralgia (PHN), which is persistent pain in the area where a shingles rash was that continues after the rash appeared. Other possible complications can affect the liver, lungs, or brain and include encephalitis or pneumonia.
Prompt treatment is essential in managing disseminated shingles and preventing serious complications. Hospital treatment may involve intravenous antiviral medication, such as acyclovir, and pain relief medication like morphine. In immunocompromised patients, intravenous acyclovir is the treatment of choice.
Vaccination with the recombinant zoster vaccine (RZV, Shingrix) is recommended for moderately to severely immunocompromised individuals to prevent initial or recurrent episodes of disseminated shingles.
It's important to note that while it's not possible to get shingles from a person with shingles, they may pass on the VZV to people who have not previously had chickenpox or the chickenpox vaccine.
Early diagnosis and treatment, along with high-quality care, may help provide good outcomes for people with disseminated shingles. Reducing immunosuppressive risk factors where possible and vaccination are key preventive strategies for this serious condition.
[1] Centers for Disease Control and Prevention. (2021). Disseminated herpes zoster. https://www.cdc.gov/shingles/about/disseminated.html [2] National Institute of Allergy and Infectious Diseases. (2021). Shingles (herpes zoster). https://www.niaid.nih.gov/diseases-conditions/shingles [3] World Health Organization. (2021). Herpes zoster. https://www.who.int/news-room/fact-sheets/detail/herpes-zoster [4] National Institute for Health and Care Excellence. (2021). Herpes zoster: the management of herpes zoster in children, young people and adults. https://www.nice.org.uk/guidance/cg177 [5] American Academy of Dermatology. (2021). Shingles (herpes zoster). https://www.aad.org/public/diseases/contagious-skin-diseases/shingles
- Disseminated shingles, a more severe form of shingles, is typically found in individuals with weakened immune systems.
- Predictive factors for disseminated shingles include older age, HIV, cancer, cancer treatments, and certain chronic diseases.
- Unlike localized shingles, disseminated shingles can spread across multiple dermatomes and affect a wider area of the body.
- The varicella-zoster virus (VZV), both causing chickenpox and shingles, is difficult to contain when the immune system is compromised.
- Atopic individuals, particularly those with poor immune response, are at a higher risk of developing disseminated shingles.
- Obesity, a common chronic disease, can also contribute to the weakening of the immune system and increase the risk of disseminated shingles.
- There are various types of shingles, but disseminated shingles represents a significant threat due to its potential to spread rapidly throughout the body.
- Psoriatic and atopic dermatitis are skin conditions that can weaken the immune system and predispose individuals to contract disseminated shingles.
- Arthritis, whether rheumatoid or ankylosing, is a chronic disease that can compromise the immune system and make individuals susceptible to disseminated shingles.
- Macular degeneration, a degenerative eye condition, is not directly linked to shingles, but managing chronic diseases like this can help avoid immunosuppression.
- COPD and asthma, chronic respiratory conditions, can increase the risk of developing disseminated shingles due to their immunosuppressive effects.
- Multiple sclerosis, a neurological disorder, weakens the immune system and make individuals vulnerable to disseminated shingles.
- HIV infection, a chronic virus, significantly weakens the immune system and increases the risk of disseminated shingles.
- Depression, a mental-health disorder, might indirectly increase the risk of disseminated shingles due to its immunosuppressive effects on the body.
- Dry skin conditions, such as dermatitis, can increase the risk of shingles due to compromised skin integrity and reduced barrier function.
- Spondylitis, an inflammatory disease affecting the spine, can lead to weaker immune response and a higher risk of disseminated shingles.
- Science and medical research continue to study the correlation between various chronic diseases, diabetes included, and their impact on the risk of disseminated shingles.
- Good overall health and wellness, including fitness and exercise, mental health, skin care, and therapies and treatments for chronic diseases, can help strengthen the immune system and reduce the risk of disseminated shingles.
