TY  - CHAP
M1  - Book, Section
TI  - Chapter 194. Varicella and Herpes Zoster
A1  - Schmader, Kenneth E.
A1  - Oxman, Michael N.
A2  - Goldsmith, Lowell A.
A2  - Katz, Stephen I.
A2  - Gilchrest, Barbara A.
A2  - Paller, Amy S.
A2  - Leffell, David J.
A2  - Wolff, Klaus
Y1  - 2012
N1  - 
T2  - Fitzpatrick's Dermatology in General Medicine, 8e
AB  - |PrintVaricella  and  Herpes  Zoster  at  a  GlanceVaricella  (chickenpox)  and  herpes  zoster  (shingles)  are  distinct  clinical  entities  caused  by  a  single  member  of  the  herpesvirus  family,  varicella-zoster  virus  (VZV).Varicella,  an  acute,  highly  contagious  exanthem  that  occurs  most  often  in  childhood,  is  the  result  of  primary  VZV  infection  of  a  susceptible  individual.The  rash  usually  begins  on  the  face  and  scalp  and  spreads  rapidly  to  the  trunk,  with  relative  sparing  of  the  extremities.  Lesions  are  scattered  rather  than  clustered,  and  progress  from  rose-colored  macules  to  papules,  vesicles,  pustules,  and  crusts.  In  varicella,  in  contrast  to  smallpox,  lesions  in  all  stages  are  usually  present  on  the  body  at  the  same  time.In  normal  children,  systemic  symptoms  are  usually  mild  and  serious  complications  are  rare.  In  adults  and  immunologically  compromised  persons  of  any  age,  varicella  is  more  likely  to  be  associated  with  life-threatening  complications.Where  use  of  varicella  vaccine  in  susceptible  children  and  adults  is  widespread,  the  incidence  of  varicella  is  markedly  reduced,  although  breakthrough  varicella  may  occur.Herpes  zoster  is  characterized  by  unilateral,  dermatomal  pain,  and  rash  that  results  from  reactivation  and  multiplication  of  endogenous  VZV  that  had  persisted  in  latent  form  within  sensory  ganglia  following  an  earlier  attack  of  varicella.The  erythematous,  maculopapular,  and  vesicular  lesions  of  herpes  zoster  are  clustered  rather  than  scattered  because  virus  reaches  the  skin  via  sensory  nerves  rather  than  viremia.Herpes  zoster  is  most  common  in  older  adults  and  immunosuppressed  individuals.Pain  is  an  important  clinical  manifestation  of  herpes  zoster,  and  the  most  common  debilitating  complication  is  chronic  pain  or  postherpetic  neuralgia  (PHN).Antiviral  therapy  and  analgesics  reduce  acute  pain;  lidocaine  patch  (5%),  high  dose  capsaicin  patch,  gabapentin,  pregabalin,  opioids,  and  tricyclic  antidepressants  may  reduce  the  pain  of  PHN.A  live  attenuated  zoster  vaccine  reduces  the  incidence  of  herpes  zoster  by  one-half  and  the  incidence  of  PHN  by  two-thirds.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessmedicine.mhmedical.com/content.aspx?aid=56088542
ER  -