Skin Diseases

Medical Summaries

Here is a record of my bout with shingles, also known as Herpes Zostrix. Shingles result from the vericella virus (reactivated chicken pox).

When you get older, shingles can appear as the result of emotional stress, or sometimes sunburn. I did have a bad sunburn on my face and arms, but that was 1 month earlier. There was zero sunburn on my head, since I had worn a cap. Or maybe it was emotional, and I didn't even know it. But there was SOME cause!

Extremely rapid onset
I awoke with bumps on the top of my head, but didn't think much about it.
Pain: Light

Pain caused me to shave my head, so I could see what was going on.
Initially, I thought that I had been bitten by a spider multiple times. I searched high and low for that spider, but never found anything.
Pain: HEAVY

Bumps on head.
At this point, it is pretty late for the vaccine.
Pain: Became OPPRESSIVE
Constant and unceasing

Bumps formed blood blisters?
A nurse friend said,
"That looks like shingles!"
Uh, oh.
Pain: OPPRESSIVE
Pain peaking around this point.

Scabby bumps on head.
The vaccine has little effect
4 to 10 days after onset,
so I didn't bother to get a shot.
Pain: OPPRESSIVE

Scabby bumps on head.
The bumps extend some distance around the scabs, and can't really be seen in the photos.
Pain: OPPRESSIVE

Scabby bumps on head.
Pain: HEAVY
I finally saw a doctor, who confirmed my layman's diagnosis. Yup! I got 'em.

(AH! I finally got a photo in focus. It's tough when you are doing self-portraits. My close-up mode has no flash, so I have to extend my arms over and behind my head as far as possible, and lower my neck. This one's pretty good.)

Scaly bumps on head.
Let the plucking begin!
The biggest chunk has been plucked (see below).
It looks bad, but it feels better.
My theory: As the scab dries, it contracts and causes the itching sensation. Remove the scab, and the itching subsides.
Pain: HEAVY
(but not related to scab plucking. It is a generalized pain, in a big circle around the scabs.)

Scabby bumps on head
Other large chunks have been plucked.
The black areas are unplucked nuggets, not yet ready to release easily.
Pain: Medium

Scabby bumps on head
One more large chunk to pluck (black).
Pain: Medium

Scabby bumps on head
All chunks plucked,
(others remain on side of head).
Pain: Light

Serious plucking again today.
Several were plucked for a second time.
Popped right off.
Pain: Light

Scabby depressions on head,
where the bumps used to be.
All chunks plucked.
The area of scabbing is now a rather pronounced depression.
Pain: Almost gone

Scabby depressions on head.
The rather pronounced depression should fill in over time, I am hoping. I think that the hair follicles are pretty much gone, though.
Pain: Almost gone

Scabby depressions in head.
Notice the lack of hair in the crater area.
Pain: Very Weak

1 month after onset.
Scabby depressions in head.
Pain: Very Weak

Reshaved head for better visibility.
Deep depressions in head - maybe 1/8".
Pain: Absent Unless Touched
(such as a pillow)

Deep depressions in head - maybe 1/8".
Pain: Absent Unless Touched
Gentle rubbing and itching helps to soothe the area - plus, it's kind of fun to stick your finger in the craters - reverse Braille.

Here is a photo showing the location of the shingles patch.
Pain: Absent Unless Touched

Deep depressions remain.
Pain: Absent Unless Touched

Deep depressions remain.
Pain: Mild PHN,
occasional twinges
on chin and scalp

About the same.
WELL past 6 weeks, and they ain't healed yet!

Deep depressions remain.
Pain: Mild PHN,
occasional twinges
on chin and scalp

About the same.

I waited too long (10 days), so I did not get the Zostavax vaccination. An early doctor visit could have reduced the severity of my attack (within 3 days).
In my case, there were no "fluid-filled blisters", as have been described.

Most shingles photos shown on the Internet occur on the face, neck, and trunk (back and chest).
All mine occurred on the top of my head (C2), left side of my head (C2), and on the left side of my chin (C3).
Apparently, this double dermatome involvement (both C2 and C3) is not common.
Most attacks are related to a single dermatome.
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  Commentary
  After about 1 week, I began to pluck the scabs from my head (Sept. 28).
  Why? They hurt like crazy, and they also itched like crazy.
  When plucked with my fingernail, I received a feeling of relief. There was very little bleeding.
  I do not advise plucking, but I personally found it very satisfying. The pain remained, but the itching was much less.
  Plucking too early will result in more pain, and greater bleeding. When they are ready, they pluck quite easily.
  For me, waiting for them to fall off on their own, was out of the question. They demand attention.

  Notice that on the biggest piece, that the hair is equally sticking out of the scab on both sides. I find this puzzling, and I have no explanation.
  Neither end seems to have come from a follicle.
  Notice that the larger scabs are about 1/8" thick, and pop off rather easily, like little nuggets.
  By Oct. 10, I had harvested 95% of the shingles. The pain has finally subsided.
 "They say" it takes 6 weeks for the wounds to heal, but I am past 8 weeks, with deep, pink scalp depressions remaining. More photos coming.

  PHN
  For some unfortunate individuals, in some cases, the pain does NOT subside, EVEN AFTER HEALING.
  This is referred to as post-herpetic neuralgia (PHN), and indicates that painkillers may be required.
  I believe that I am getting a mild case now - twinges that come and go.
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Youth Disease
Usually caught in childhood, but can be caught much later.

Symptoms

Chicken Pox - eruption of fluid-filled blisters ALL OVER the skin and mucous membranes
Once the chicken pox virus is contracted, it remains in the body forever.

Treatment

Vaccination
Vericella vaccine must be given before exposure to the virus.

Older Person Disease
Usually appears after age 50. Frequency of occurrence increases greatly with age. It is estimated that 50% of all seniors over age 85 have had shingles.

Symptoms

Shingles - EXTREMELY PAINFUL rash and scabs, resulting from the reactivation of the long-dormant chicken pox virus, but usually only along a SINGLE SPINAL NERVE (dermatome).
Cervical dermatomes - 8
Thoracic dermatomes - 6
Lumbar dermatomes - 5
Sacral dermatomes - 5

Treatment

Zostavax can reduce the severity and symptoms of the attack, if injected within 72 hours of the outbreak. The trouble is, that it usually takes that long to figure out what is going on. But it is not too late to get some pain pills. Do it.