|Pathology of Herpes Zoster
(Shingles) caused by Varicella-Zoster Virus
Dr Sampurna Roy MD April 2016
Herpes zoster (shingles) is a recurrent, painful, erythematous vesicular eruption caused by the reactivation of latent varicella-zoster virus in an individual who had chickenpox years earlier.
Adults with shingles may transmit the virus to children and cause chickenpox.
During the latent phase, the virus resides in the dorsal root spinal ganglion or the cranial nerve ganglion.
On reactivation, the virus spreads from the ganglia along sensory nerves to peripheral nerves of the sensory dermatomes.
Attacks of shingles produce cutaneous lesions that resemble varicella.
In shingles, however, the eruptions are limited to one or more sensory dermatomes, and the vesicles or bullae may be few.
Shingles is painful, especially in older people, in contrast to the painless vesicles of children with chickenpox.
Eventually the scales over the vesicles slough, and symptoms remit until another attack.
Herpes folliculitis is a rare manifestation of herpes virus infection and it is often misdiagnosed. Diagnostic criteria are not well established, only 24 patients being reported in the literature.
In biopsy specimens taken from herpes virus infections, involvement of follicular units is more commonly encountered in varicella zoster virus infections compared with HSV infections.
Early in the course, herpes folliculitis presents as lymphocytic folliculitis devoid of epithelial changes considered to be diagnostic of herpes virus infections.
Exclusive involvement of follicles is rather typical of zoster.,Herpes folliculitis: clinical, histopathological, and molecular pathologic observations.
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