Shingles is an inflammation of a nerve which causes pain, itching, a rash, or all three. It affects an estimated 300,000 people in the United States each year.
The word shingles comes from the Latin cingulus meaning a girdle. It has been known from biblical times as the creeping eruption that girdles the body.
Shingles has nothing to do with "nerves" in the emotional sense. You might hear someone say, "Oh! She's a nervous wreck. That's why she came down with the shingles." Nonsense. Because shingles affects a nerve, many people mistake this to mean that it is a nervous condition.
The condition has affected its share of celebrities-Golda Meir, Arthur Rubinstein, and former President Nixon immediately come to mind-and that notoriety also has led to many misconceptions about it.
Is Shingles Contagious?
Shingles, the technical name for which is herpes zoster, is caused by a virus. It's the same virus that's responsible for chicken pox; it actually represents a reactivation of latent chicken pox viruses from an earlier infection. Like chicken pox, shingles is usually a once-in-a-lifetime condition. Unlike chicken pox, however, it is only slightly contagious .
Although shingles can affect any age group, it's more prevalent and more painful in older people. And since shingles can attack any nerve, no area of the body surface is immune. Depending upon the severity of the pain and the location of the nerve involved, one can mistake shingles in its early stages for attacks of appendicitis, kidney stones, gallbladder trouble, pleurisy, and even facial neuralgia and toothache.
The virus of shingles attacks a nerve root in the brain or spinal cord and follows the course of that nerve only. Early symptoms include a feeling of fatigue, headache, a slight fever, and a mild drawing pain over the involved area. The pain characteristically involves only one side.
The infected areas of the skin become red and itchy, and a rash, made up of small blisters, often follows, usually in groups, along the path of the affected nerve. These blisters last for about two weeks and then rupture, forming crusts.
Because each nerve extends to a very specific part of the body on either the left or right side, the blisters usually have a ribbon like or branching configuration, forming a semicircle on one side of the body.
In children and young adults, shingles usually runs a mild and quick course, and the average sufferer will recover without any therapy. In older people, however, the pain may be excruciating, the itching may be intense, and the blisters may become crusted and infected.
Complications can arise from even the mildest form of shingles, so it is important that a physician examine any suspected case. Your doctor can prescribe various internal medications, such as antibiotics, cortisone-like drugs, analgesics and antihistamines, to relieve the pain, itching and inflammation, as well as soothing salves and ointments to relieve the dermatitis and possibly prevent spread of the disease.
When shingles involves the eye, you should consult an ophthalmologist (a physician who specializes in diseases of the eye) to prevent severe damage to the cornea. Arthur Rubinstein, one of the country's greatest pianists, had to retire from the concert stage in 1976, when an attack of shingles left him nearly blind.
Other complications of shingles which may occur are scarring where the blisters had been, extreme fatigue and malaise during the period of recovery, and persistent dull or severe pain (postherpetic neuralgia) which may linger for months or longer after the rash has disappeared.
Occurring in more than half the patients over the age of fifty, this oftentimes exquisite pain that follows an episode of herpes zoster, can be extremely disabling. A variety of attempts to control or reduce this relentless torment has met with variable success. A new topical medication, capsaicin, holds some promise in relieving some of this distressing symptom. This over-the-counter product, called Zostrix, should be applied three or four times a day, with relief of the pain anticipated in about two or three weeks. It should be continued for a period of several months, and for those who have been suffering from chronic pain, treatment over several years should be expected.
While there are no cures, as such, for shingles, many dermatologists have been prescribing acyclovir (Zovirax) orally in large doses in an attempt to shorten the course of the disease and, possibly, to diminish some of the complications.
There are no measures known to prevent shingles. You may save yourself some worry, however, by avoiding direct contact with someone who has shingles. If you are older, and therefore more susceptible to shingles, you should also avoid young children who have chicken pox. Doctors will sometimes prescribe injections of gamma globulin for patients who are otherwise very ill and who have been exposed to persons who have either chicken pox or shingles.
If you do have shingles-some dermatologists call this "second-time" chicken pox-refrain from contact with infants and children who have never had chicken pox, and avoid people who are undergoing chemotherapy.
Shingles almost always limits itself to one side of the body. So, if you have a rash on both sides, chances are that shingles is not the culprit.
Wednesday, May 6, 2009
Saturday, April 18, 2009
Types of ECZEMA
Itch. . . scratch. . . .
Itch. . . scratch. . . scratch. . . .
In brief, this is the story of what people frequently call
"eczema"and what dermatologists call "atopic dermatitis." It is the disease that starts from scratch and one that may last a lifetime. It is the eczema of infancy, the chronic, relentless dermatitis of childhood and adolescence, and the fierce and uncontrollable itching of the adult.
Eczema is a general term which, to most people, means a diffuse rash with itching. It is a synonym for dermatitis, which literally means "inflammation of the skin."
But when physicians speak of eczema, they usually refer to the persistent, incessant itchy eruption that almost invariably begins in infancy, is inherited, is often accompanied in later years by hay fever or asthma, and in rare circumstances lasts a lifetime. It is a topic dermatitis, a disease that affects about 10 millions people in the United States alone.
No one yet knows the "why" of this virtually uncontrollable, allergic process. It begins with itching on a perfectly normal looking skin. You then rub, claw, tear, and scratch where it itches and you, yourself, produce the rash we know of as eczema.
There are three different types or "stages" of atopic dermatitis.
The infantile form. This usually begins about six or eight weeks after birth. The itching is often intense and lasts up until about the age of two years. The rash, which almost always affects the cheeks and mouth, usually worsens after vaccinations and immunization injections and during the teething phase. During the second year of life, the itchy areas develop over the hands, wrists, and outer portions of the arms and legs.
The childhood type. While the infantile form in over half the cases fades out between the ages of two and four, it may continue into the so-called childhood type of eczema. The areas that suffer most here are the creases in the elbows and the bends of the knees. The affected areas are more dry, the skin becomes thicker and grayish in color, the itching becomes fierce, and the children are restless, anxious, and hyperactive.
Of all the eczemas that occur during childhood, atopic dermatitis is not only the most prevalent disorder, but it is also one of the most mystifying and difficult to manage.
The adolescent and adult types. The infantile and childhood eczemas often disappear after a few years only to reappear in late adolescence. While it usually fades away by the age of thirty, it may persist throughout the entire lifetime of some unfortunate person. The itching, again, may be intense and is usually worse at night. The areas affected are the bends of the elbows and knees, the face, the shoulders, and the upper back. The itchy and scratched skin becomes thick and leathery, darker than the surrounding skin, and develops dry scales.
Another characteristic feature is the accentuated groove beneath the lower eyelids. This is called the atopic pleat.
The management of eczema is an enormous challenge for the physician. No one treatment for eczema works for everyone, since the areas involved and the degree of itching affect different people in different ways. At best we try to alleviate the intense itching which, in essence, is the disease. Interrupt and stop this fierce symptom and we break the itch-scratch reflex which is wholly responsible for the clinical manifestation-the rash.
Itch. . . scratch. . . scratch. . . .
In brief, this is the story of what people frequently call
"eczema"and what dermatologists call "atopic dermatitis." It is the disease that starts from scratch and one that may last a lifetime. It is the eczema of infancy, the chronic, relentless dermatitis of childhood and adolescence, and the fierce and uncontrollable itching of the adult.
Eczema is a general term which, to most people, means a diffuse rash with itching. It is a synonym for dermatitis, which literally means "inflammation of the skin."
But when physicians speak of eczema, they usually refer to the persistent, incessant itchy eruption that almost invariably begins in infancy, is inherited, is often accompanied in later years by hay fever or asthma, and in rare circumstances lasts a lifetime. It is a topic dermatitis, a disease that affects about 10 millions people in the United States alone.
No one yet knows the "why" of this virtually uncontrollable, allergic process. It begins with itching on a perfectly normal looking skin. You then rub, claw, tear, and scratch where it itches and you, yourself, produce the rash we know of as eczema.
There are three different types or "stages" of atopic dermatitis.
The infantile form. This usually begins about six or eight weeks after birth. The itching is often intense and lasts up until about the age of two years. The rash, which almost always affects the cheeks and mouth, usually worsens after vaccinations and immunization injections and during the teething phase. During the second year of life, the itchy areas develop over the hands, wrists, and outer portions of the arms and legs.
The childhood type. While the infantile form in over half the cases fades out between the ages of two and four, it may continue into the so-called childhood type of eczema. The areas that suffer most here are the creases in the elbows and the bends of the knees. The affected areas are more dry, the skin becomes thicker and grayish in color, the itching becomes fierce, and the children are restless, anxious, and hyperactive.
Of all the eczemas that occur during childhood, atopic dermatitis is not only the most prevalent disorder, but it is also one of the most mystifying and difficult to manage.
The adolescent and adult types. The infantile and childhood eczemas often disappear after a few years only to reappear in late adolescence. While it usually fades away by the age of thirty, it may persist throughout the entire lifetime of some unfortunate person. The itching, again, may be intense and is usually worse at night. The areas affected are the bends of the elbows and knees, the face, the shoulders, and the upper back. The itchy and scratched skin becomes thick and leathery, darker than the surrounding skin, and develops dry scales.
Another characteristic feature is the accentuated groove beneath the lower eyelids. This is called the atopic pleat.
The management of eczema is an enormous challenge for the physician. No one treatment for eczema works for everyone, since the areas involved and the degree of itching affect different people in different ways. At best we try to alleviate the intense itching which, in essence, is the disease. Interrupt and stop this fierce symptom and we break the itch-scratch reflex which is wholly responsible for the clinical manifestation-the rash.
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