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Infectious Diseases

Shingles-herpes zoster

02/18/2002

Question:

I am on my four bout of having shingles. How can I prevent this from happening again in the future?

Answer:

Four episodes of herpes zoster are rather unusual, but not unheard of. I think it would be advisable to perform some in depth investigation to make sure your cellular immune system is working fine: Rule out HIV infection, perhaps other immune suppressive states. Are the `zoster` lesions always in the same area of your skin? In that case I would suspect a dermatomal herpes simplex, which may have multiple recurrences and is observed in otherwise immunocompetent individuals. I would suggest visiting your doctor while you have ACTIVE lesions, and obtaining some baseline blood work as well as a viral culture of the lesions to make a definitive diagnosis of herpes zoster or herpes simplex from the skin lesions: they cannot be distinguished with certainty based on the aspect of the lesions. After a more precise diagnosis is made your doctor can devise an adequate treatment to prevent or delay recurrences. Treatment with antivirals can be helpful, but it is necessary to establish a correct diagnosis first.

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Response by:

Francisco   Gomez, MD Francisco Gomez, MD
Assistant Professor
College of Medicine
University of Cincinnati