Herpes zoster (shingles) is a local manifestation of reactivation of latent varicella infection in the dorsal ganglia radix. Vesicular lesions appear as erythema limited basis in areas of skin, which follows the course of a single sensory nerve ganglia or group radix dorsalis. The lesions can appear in the form of an irregular bubble gang during the course of the nerve, usually unilateral. Vesicles located deeper and gather more closely than chicken pox, herpes zoster and varicella are histologically similar to each other. Almost always accompanied by pain and paresthesias once, and about 30% of adults who fell ill suffered from postherpetic neuralgia herpes.
Incidence of herpes zoster and postherpetic neuralgia increases with age. From observation it was found that nearly 10% of children who received cancer treatment tend to get shingles, those with HIV infection also have a risk of exposure to herpes zoster. Persons with immunosuppression and those who are diagnosed with malignant tumors, extensive lesions such as chickenpox can appear outside the dermatome; like chicken pox lesions can also occur in normal people but with a smaller number of lesions. Intra-uterine infection and chicken pox suffered before the age of 2 years was associated with the appearance of zoster at a young age. Sometimes the eruptions like chicken pox appeared several days after herpes zoster, and very rarely occurs secondary eruption of zoster after chickenpox.
Laboratory tests, such as finding the virus by using electron microscopy, virus isolation in cell culture; prove the existence of viral antigens on smear preparations by using the FA method, the viral DNA, or PCR, or proving an increase in serum antibody titer, is not routinely done but useful in difficult cases and for epidemiological studies.
In the era of vaccines, virus identification tests to distinguish the vaccine virus from wild virus may be necessary in certain situations (for example, to find out whether the appearance of herpes zoster, the vaccine recipients caused by the vaccine virus or wild virus). Various antibody examination is now available commercially, but this examination is less sensitive to possible intervention, post-immunization immunity; giant cells with a nucleus can be seen many of the stocks taken from the bottom of the lesion with Giemsa staining; giant cells are not found in the vaccinia but can be found at herpes simplex lesions.
Thus the discovery of giant cells is not specific to varicella infection, examination by direct Rapid antibody testing has a more precise diagnostic value