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He Herpes zoster, also known as 'shingles', it is due to a reactivation of the varicella-zoster virus. It consists of an infection that characteristically affects a nervous region and that can be painful. It can affect anyone who has had chickenpox previously and, although its incidence may be mild in children, it increases in those who had it during the first year of life.
The exact cause of this reactivation is unknown. When a person comes into contact with the varicella-zoster virus for the first time, it is usually during childhood and manifests as the classic chickenpox rash. After infection, the virus remains inactive (asleep) in the nerve ganglia for the rest of life and can reactivate after months or years, causing the Herpes zoster.
There are some factors that can predispose to this reactivation, such as a decrease in the body's defenses caused by diseases, medications, advanced age ... Although it can also affect children who have been correctly vaccinated against chickenpox, its frequency it is much less than after suffering the disease.
The first thing patients notice is a burning or tickling type discomfort in the area where later skin lesions appear in the form of vesicles (granites with fluid inside) small and grouped, which follow the path of a nerve.
These vesicles, with the passage of days, dry out and become scabs. The most frequent location is on the trunk (on the back or on the side), with a unilateral distribution. These lesions last 10 to 14 days and do not usually leave a scar in most cases. The scabs usually come off about 2 to 4 weeks after the rash starts.
Other symptoms that we can find are fever, general malaise, headache, muscle pain, swollen glands ...
Once the skin lesions have disappeared, pain in the area, called postherpetic neuralgia, may persist, but this complication in children is rare. The main complication in pediatrics is superinfection by a bacterium.
The diagnosis is established by the clinic, not being necessary to carry out complementary examinations in most of the cases. The appearance of the lesions, together with the typical distribution and the history of having had chickenpox, usually lead to suspicion of this disease. If there are doubts, there is the option of doing different laboratory techniques to investigate the presence of the virus in the lesions.
The herpes zoster infection In healthy children, it does not usually require treatment, only symptomatic treatment in case of pain or itching and prevention of bacterial superinfection with adequate hygiene of the lesions. In certain circumstances, antiviral treatment may be indicated, but especially in children with impaired defenses. It is important to know that if herpes zoster appears on the face, near the eye, an ophthalmologist should be consulted.
In relation to contagion, we must bear in mind that the fluid from the vesicles is contagious for someone who has not had chickenpox, so children with shingles should stay home until all lesions have crusted over. The contagion would be in the form of chickenpox in those people who have not had it or are not vaccinated.
There is no way to totally prevent shingles. However, because the chickenpox vaccine reduces its risk and severity, it is recommended keep the vaccination schedule up to date. Newborns, pregnant women, people with weakened immune systems, and those not immune to chickenpox should avoid contact with people with shingles until the rash is completely healed.
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