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Thursday, November 8, 2012

Shingle (herpes zoster) and chemotherapy

Varicella-zoster virus (VZV) can cause two types of diseases.  First, primary infection with VZV results in varicella (chickenpox), characterized by skin blister.   After this infection, the virus could live dormant in your nerves.   The 2nd type of disease is what we called Herpes zoster or shingles.  Herpes zoster is due to reactivation of VZ virus that live dormant earlier in your nerves - not the same as sexually transmitted herpes. Herpes zoster/ shingle usually causes painful, one sided painful blisters on your skin.  Before the rashes or blisters show, you may have nerve symptoms of pain, itching, burning, or tingling. The rash has blisters that scab over in about a week. Although shingles isn’t contagious, the virus can spread to others and can cause chickenpox.

We don't know what exactly causing the reactivation of the VS virus in shingle but it occurs more often in immunosuppressed persons such as with HIV or in chemotherapy.  Thus, if you have any painful skin rash or blisters during chemotherapy, do come see your oncologists or PCP.  Your doctor may give you antiviral therapy to help healing of the rash and decrease the painful inflamed nerves.  Antiviral medications are Famciclovir or Acyclovir or Valacyclovir pills.  Pain medication such as tylenol or stronger narcotic prescription may be needed depending the degree of your pain.

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