Week 4: How do I know if what I have is Shingles?

The diagnosis of Shingles is pretty simple in fact.  You can seek help from your primary care provider, or other health providers.  Sometimes, a provider may refer you to a dermatologist.  Dermatologists are physicians that specialize in treating conditions of the skin (DermNet NZ, 2014). 

http://www.dermnetnz.org/dermatologist.html

To diagnose shingles, the physician will most often observe your skin lesions, and ask some questions.  These questions may include… “Have you ever had the chicken pox?”  “ When did this rash first appear?”  “Describe your pain that you are feeling around the affected area.” “What have you been doing to treat this rash?”  If the provider is still uncertain about the characteristics of the rash, along with your responses to their questions, they may scrape off part of the blister to be examined under a microscope (American Academy of Dermatology, 2015). 

Individuals who are immunocompromised may have a rash that expands outside of the one dermatome.  This can throw providers off in their diagnosis of Shingles since that dermatome pattern is a hallmark sign (CDC, 2014). By looking at the sample, physicians can appropriately treat the rash if they were previously uncertain about what was causing it.  The shingles virus, a different virus, bacteria, an allergic response, or something else could cause a rash.  Diagnosis becomes more complicated if your rash has not erupted before seeking medical attention (CDC, 2014).  In these instances, a provider might perform a blood test.  With the blood test, the provider is looking to see if your body has formed antibodies to the virus.  This means your body has been previously exposed, and has built defenders to attack the virus if it enters your body again.  This is not considered the best practice since most individuals have received the vaccine (CDC, 2014). 

It is incredibly important to seek care if you are concerned about acute pain or a visible rash.  Although shingles can clear on its own, you may be left with pain, numbness, and itching for years to come (ADA, 2015).  An early diagnosis is the only thing that can save you this trouble.  With early diagnosis comes early treatment. 

Here is an overview from a Dermatologist discussing different rash distributions, what nerves are involved, and why early diagnosis is important.

References:

American Academy of Dermatology. (2015). How do dermatologists diagnose shingles? Shingles: Diagnosis, Treatment, and Outcome.  Retrieved from https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q---t/shingles/diagnosis-treatment

Centers for Disease Control and Prevention. (May, 2014). Diagnosis and Testing. Shingles (Herpes Zoster). Retrieved from http://www.cdc.gov/shingles/hcp/diagnosis-testing.html

DermNet NZ. (December, 2014). What is a Dermatologist? What is Dermatology? Retrieved from http://www.dermnetnz.org/dermatologist.html

Photos

Oakview Dermatology. What is a Physician Assistant? Physician Assistant. Retrieved from http://www.oakviewderm.com/physician-assistant.html