What Does Genital Herpes Look Like :

Herpes zoster (shingles, zoster) is a common neurocutaneous disease resulting from reactivation of latent varicella–zoster virus (VZV) infection acquired during primary VZV-infection (varicella, chickenpox). Herpes zoster presents as a painful characteristically unilateral cutaneous rash in the sensory innervation region of a spinal nerve or a cranial nerve. Unlike varicella herpes zoster is a sporadic disease with an estimated lifetime incidence of 10–20%. Whereas, varicella is generally a disease of childhood, herpes zoster becomes more common with increasing age.

Factors that decrease immune function, such as human immunodeficiency virus infection, chemotherapy, malignancies and chronic corticosteroid use may also increase the risk of developing herpes zoster. The main risk factor for the development of herpes zoster, however is increasing age, leading to a decline of VZV-specific cell-mediated immunity. Incidence of zoster rises steadily until adulthood and remains constant with about 2–3 cases per 1,000 per year until the end of the fourth decade of life.

In persons older than 50 years of age the incidence strongly increases to approximately 5 cases per 1,000 persons per year. Individuals in the sixth to seventh decade have an incidence rate of 6–7 cases per 1,000 and individuals beyond the age of 80 have an incidence of more than 10 cases per 1,000 per year. According to Hope-Simpson [2] more than half of all people who reach 85 years of age will develop herpes zoster at any point of their life.

Persons older than 50 years of age affected by herpes zoster may suffer a significant decrease of quality of life. These persons and immunocompromised individuals of any age are at increased risk for severe complications involving the skin, the eye, internal organs and the peripheral and central nervous system. About 20% of patients with shingles develop prolonged pain and postherpetic neuralgia (PHN). The most established risk factor for PHN is again age. This complication occurs nearly 50 times more often in patients older than 50 years of age. Other possible risk factors for the development of PHN are ophthalmic zoster, zoster oticus and a history of prodromal pain before appearance of the rash.

Growing life expectancy and the increasing number of elderly in Europe has resulted in a higher population risk for herpes zoster and chronic zoster pain. HIV-infected individuals and adults suffering from cancer have a much higher herpes zoster incidence than immunocompetent persons of the same age. The occurrence of herpes zoster in HIV-infected patients, however does not appear to increase the risk of acquired immunodeficiency syndrome (AIDS) and is less dependent on the CD4-count than AIDS-related opportunistic infections.

Furthermore, there is no evidence that herpes zoster heralds the onset of an underlying malignancy.