Disseminated Herpes Zoster Definition, Rash, Symptoms, Causes, Treatment

Herpes zoster, often known as shingles, is a widespread skin infection that affects approximately 10 to 20 % of the total population at some point in their lives. The elderly and immunocompromised individuals have a higher risk of developing the condition. It is well known that there is a link between malignancy and this viral infection.  It happens when a dormant VZV infection wakes up again. The typical rash shows up on one side of the body, most often in the thoracic and lumbar regions, but it can also show up on the face.

Acute herpes zoster is a condition that nearly exclusively affects adults. Herpes zoster in children is an extremely rare condition that is almost always confined to people who are immunocompromised or who are battling cancer. Children who contracted varicella at a young age are also susceptible to it. It is possible for immunocompetent children to develop this condition as a result of infection with VZV while still in the womb or postnatal exposure to this virus at a young age. The fever is the first sign of the illness, which starts with pain in the area where the affected sensory ganglia are present.

Disseminated Herpes Zoster Definition

Disseminated herpes zoster is generally defined as an outbreak of more than 10–12 vesicles outside of the skin that happens 7–14 days after classic herpes zoster. Most of the time, it's hard to tell the difference between this outbreak and varicella.

It mostly affects elderly or disabled people, notably those with AIDS or lymphoreticular cancer. A very important risk factor for forecasting the spread of the disease is low serum antibody levels against the VZV virus. The dermatomal lesions might occasionally be gangrenous or hemorrhagic.

Rashes and other Symptoms

The rash caused by herpes zoster most frequently appears on one or two dermatomes that are next to one another (localized zoster). Rash typically appears on a thoracic dermatome or the midsection of the body. Typically, the rash will not extend over the midline of the body. In a rarer instance, the rash may involve 3 or more dermatomes and be more extensive. This medical condition is referred to as disseminated zoster. In most cases, this condition mainly manifests in individuals whose immune systems are already impaired or suppressed. It can be hard to tell the difference between disseminated zoster and varicella.

The rash frequently causes discomfort in the form of pain, itchiness, or tingling. These symptoms may appear many days before the rash. In the prodromal stage, some individuals may also experience headaches, photophobia (sensitivity to bright light), and malaise.

Causes

The varicella-zoster virus (VZV) may remain latent in the dorsal root ganglia or cranial nerve sensory ganglia following an initial varicella infection, and its subsequent reactivation causes this outbreak. In order to diagnose a disseminated herpes zoster infection, 20 or more blisters must emerge systemically within a week of exhibiting normal herpes zoster skin signs. This occurs quite seldom compared to the general herpes zoster infection, which most often affects immune-compromised elderly adults, patients with hematological malignancies, or HIV/AIDS patients receiving chemotherapy. 

Treatment

The use of antiviral medicine may be an option for treating disseminated shingles. A hospital stay may be necessary for those with a compromised immune system. Antiviral medication, such as acyclovir, may be administered intravenously as part of the treatment process in a medical facility. Additionally, doctors may prescribe patients morphine or other painkillers. If the patient's symptoms are showing signs of improvement, they may then be able to switch to taking acyclovir orally and continue their rehabilitation at home.