Herpes_Zoster

Question 1

What is it?

Answer 1

Reactivation of latent varicella zoster in sensory dorsal root or cranial nerve ganglia

(ref: Australian Prescriber 2012)

Question 2

Presentation?

Answer 2

Pain, itching
Rash can develop a few days to a few weeks after, cant have headache, myalgia.

–>Other presentations
herpes opthalmicus
keratitis, uveitis, glaucoma
Uncommonly associated with facial n: loss of taste/facial weakness, vesicles in the ext auditory canal
–> asceptic meningitis, peripheral motor

(ref: Australian Prescriber 2012)

Question 3

When is the rash considered non-infectious?

Answer 3

When lesions have crusted

ref: Australian Prescriber 2012

Question 4

Postherpatic neuralgia.

What % of >80 year old get this?

Answer 4

30%, worse with increasing age

• -> intermittent, burning, shooting pain
• -> allodonyia is also present in some cases

(ref: Australian Prescriber 2012)

Question 5

When should antivirals be started?

Answer 5

Can start within 72 hours of the onset of the rash

All patients with her zoster opthalmicus should receive antivirals even after the rash

(ref: Australian Prescriber 2012)

Question 6

Which medications for treatment?

Answer 6

Famciclovir 250mg tds for 7 days
Valaciclovir 1g tds for 7 days
(ref: Australian Prescriber 2012)

Question 7

How to avoid transmission?

Answer 7

Cover up the lesions with a non-adherent dressing

ref: Australian Prescriber 2012