OCT 04, 2016
In this video, Dr. Elisabeth J. Cohen discusses epidemiology, presentation, diagnosis, and vaccines for varicella zoster virus (VZV) and herpes zoster. Shingles and other complications occur when latent virus is reactivated in an adult who had a past chickenpox infection, and can typically be diagnosed by the presence of a unilateral vesicular rash in a dermatomal distribution. However, a chronic infection can present without a rash (herpes zoster sine herpete) as severe uveitis or keratitis when the ophthalmic division of the trigeminal nerve is involved, termed zoster ophthalmicus. VZV can also trigger temporal (giant cell) arteritis. The live zoster vaccine reduces disease burden and incidence by 61% and 51%, respectively, but shows small risk of exacerbating uveitis or keratitis, and there have been 2 cases of acute retinal necrosis.