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Herpes zoster as a systemic disease.

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Herpes zoster (shingles) is a viral infection that can affect multiple organ systems beyond the skin and nervous system. Emerging case reports reveal diverse presentations and rare, severe complications, suggesting a systemic nature.

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Area of Science:

  • Virology
  • Dermatology
  • Neurology
  • Systemic Diseases

Background:

  • Herpes zoster (shingles) is a viral infection primarily affecting the skin and nervous system.
  • Incidence rates are 3-5 per 1000 person-years, increasing with age.
  • Traditional understanding focuses on cutaneous and neurological manifestations.

Purpose of the Study:

  • To highlight the expanding spectrum of herpes zoster (HZ) manifestations.
  • To underscore the potential for systemic involvement beyond typical presentations.
  • To emphasize the diagnostic challenges posed by atypical HZ complications.

Main Methods:

  • Review of emerging case reports and literature on VZV (Varicella-Zoster Virus) incidence.
  • Analysis of reported atypical localizations, clinical presentations, and complications.
  • Synthesis of findings related to dermatologic, neurologic, and systemic manifestations.

Main Results:

  • Skin lesions remain key for HZ diagnosis.
  • Postherpetic neuralgia (PHN) is the most common complication.
  • Atypical complications include otorhinolaryngologic, ophthalmologic, neurological (hemiparesis/hemiplegia, encephalitis, myelitis), gastroenterologic, and nephrologic issues.
  • Increased HZ risk observed in patients with inflammatory bowel disease.

Conclusions:

  • Herpes zoster exhibits a broader range of manifestations than previously recognized.
  • The virus can cause severe systemic complications, challenging its classification as solely a skin and nerve disease.
  • Recognition of systemic involvement is crucial for accurate diagnosis and management of HZ.