Shingles and herpes are two infectious disease conditions caused by viruses. The key difference between shingles and herpes is that shingles is caused the varicella zoster virus but herpes is caused by the herpes simplex virus. After the initial infection, varicella zoster virus can remain dormant in the dorsal root ganglia of sensory nerves and get reactivated whenever the person’s immunity weakens. The reactivation of the varicella zoster virus in this manner is called shingles. Herpes is the infection that is caused by Herpes Simplex Virus (HSV).
CONTENTS
1. Overview and Key Difference
2. What is Shingles
3. What is Herpes
4. Similarities Between Shingles and Herpes
5. Side by Side Comparison – Shingles vs Herpes in Tabular Form
6. Summary
What is Shingles?
After the initial infection, varicella zoster virus can remain dormant in the dorsal root ganglia of sensory nerves and get reactivated whenever the person’s immunity weakens. The reactivation of the varicella zoster virus in this manner is called shingles.
Clinical Features
- Usually, there is a burning sensation or a pain in the affected dermatome. A rash characterized by the presence of vesicles often appears in this region with distant chicken pox-like lesions.
- Sometimes there can be paresthesia without any associated dermatological manifestations
- Multi dermatomal involvement, severe disease and prolonged duration of the symptoms suggest underlying immune deficiencies such as HIV.
Usually, the thoracic dermatomes are the regions that are commonly affected by the reactivation of the virus. Vesicles can appear in the cornea when there is a reactivation of the virus in the ophthalmic division of the trigeminal nerve. These vesicles can rupture, giving rise to corneal ulcerations which require the immediate attention of an ophthalmologist to avoid blindness.
Figure 01: Progression of Shingles
When the viruses in the geniculate ganglion get reactivated it causes the Ramsay Hunt syndrome which has the following hallmark features.
- Facial palsy
- Ipsilateral loss of taste
- Buccal ulceration
- A rash in the external auditory canal
When the sacral nerve roots are involved there can be bladder and bowel dysfunction.
Figure 02: Shingles
Other Rare Manifestations of Shingles
- Cranial nerve palsies
- Myelitis
- Encephalitis
- Granulomatous cerebral angiitis
There can be post herpetic neuralgia in some patients for about six months after the reactivation. The incidence of post herpetic neuralgia increases with advanced age.
Management
- Treatment with acyclovir can be useful in minimizing the pain
- Strong analgesic agents and other drugs such as amitriptyline have to be administered to relieve the pain due to post herpetic neuralgia.
What is Herpes?
Herpes is the infection that is caused by the Herpes Simplex Virus (HSV). Although there are several serotypes of HSV, HSV 6 and 7 are the most common causative agents of the infection.
HSV 6 is a lymphotropic virus known to be causing pediatric viral exanthem (exanthem subitum).Occasionally, it can cause a syndrome similar to the infectious mononucleosis. HSV 7 also causes viral exanthem in childhood but rarely infects immunocompromised hosts.
Clinical Features
Exanthem subitum which is also known as roseola infantum or sixth disease has the following symptoms.
- High fever
- A maculopapular rash appears with the resolution of fever
- It is possible to have fever with convulsions without a rash
- The other rare manifestations include infectious mononucleosis-like syndrome and hepatitis
- In the immunocompromised patients, there can be complications such as hepatitis, encephalitis, pneumonitis, and cytopenia
Diagnosis
Diagnosis is usually based on the clinical features. Any doubts can be eliminated by doing a serum antibody test or DNA detection.
Management
No medications are required since the disease is self -limiting. Ganciclovir is used in the immunocompromised hosts who are infected with HSV6.
Figure 03: Herpes
What are the Similarities Between Shingles and Herpes?
- Both are infectious diseases caused by viruses.
- The appearance of a rash is a common symptom of both diseases.
What is the Difference Between Shingles and Herpes?
Shingles vs Herpes |
|
| Shingles is a viral disease characterized by a painful skin rash with blisters in a localized area. | Herpes is the infection that is caused by the Herpes Simplex Virus (HSV). |
| Virus | |
| This is caused by varicella zoster virus. | This is caused by herpes simplex virus. |
| Type of Infection | |
| This is a reactivation after the initial infection. | This is an initial infection. |
Summary – Shingles vs Herpes
Shingles and herpes are two infectious diseases caused by varicella zoster virus and herpes simplex virus respectively. This difference in the causative agents can be considered as the main difference between shingles and herpes.
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References:
1. Colledge, Nicki R, Brian R. Walker, Stuart Ralston, and Stanley Davidson. Davidson’s Principles and Practice of Medicine. Edinburgh: Churchill Livingstone/Elsevier, 2014 Print.
Image Courtesy:
1. “A Course of Shingles diagram” By Renee Gordon – (Public Domain) via Commons Wikimedia
2. “Shingles” By James Heilman, MD – Own work (CC BY-SA 3.0) via Commons Wikimedia
3. “Herpes Infection” By BruceBlaus – Own work (CC BY-SA 4.0) via Commons Wikimedia