Talk:Shingles

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Good article Shingles has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
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Added text[edit]

Added public domain text from http://www.ninds.nih.gov/health_and_medical/disorders/shingles_doc.htm — Preceding unsigned comment added by 213.253.39.89 (talk) 05:03, 5 August 2002 (UTC)

Prevention[edit]

Does anyone have statistics about people developing shingles from having full-blown out break of Chickenpox vs. being vaccinated? It would be interesting to see if the inert Varicella-zoster virus vaccination reduced the occurrence of Shingles. If so then this method of shingle prevention is copyrighted by me --Supercoop 16:01, 2004 Oct 13 (UTC) and released to the community under GFDL. :)

Primary name[edit]

1. I'd like to replace occurrences of the word "shingles" in the body of the article for the article title, would that be OK? Fgnievinski (talk) 03:13, 5 July 2015 (UTC)

2. ICD-10 seems to favor just "zoster" instead of "herpes zoster" [1] -- would you agree to rename the article accordingly, moving it over its redirect at zoster? Fgnievinski (talk) 03:13, 5 July 2015 (UTC)

Shingles is the more common name. Maybe we should move the article to shingles? We are trying to write for a more general audience and the word shingles will not be confused with any other medical condition that I know off. Doc James (talk · contribs · email)
I think the article name is no big deal - Shingles redirects here, and the first line makes it clear that Shingles is one of the names. But if it comes to a !vote, I would support a move to Shingles. In the body of the article, I do think we should refer to "shingles" instead of "zoster" or "herpes zoster" for sure, as that is the more common name among the public. Jytdog (talk) 03:46, 5 July 2015 (UTC)
I went ahead with uniforming usage to "shingles" instead of mixed shingles/herpes zoster/zoster. Can we now possibly rename the article, too? Also not sure if we want to harmonize zoster vaccine and disseminated herpes zoster and Herpes zoster ophthalmicus. Thanks. Fgnievinski (talk) 04:48, 5 July 2015 (UTC)

Encourage you to find out which is the more commonly used term in high quality medical sources. Matthew Ferguson (talk) 05:36, 5 July 2015 (UTC)

@Matthew Ferguson 57: Based on the sources cited in the present article, it's "herpes zoster". But I'm with the impression that in WP common names trump medical names, hence the change. Fgnievinski (talk) 05:41, 5 July 2015 (UTC)

This issue comes up often, whether we should name medical articles according to common name or according to MEDMOS, which is worded roughly as I described above. Matthew Ferguson (talk) 05:43, 5 July 2015 (UTC)

probably according to MEDMOS is best--Ozzie10aaaa (talk) 10:02, 5 July 2015 (UTC)
Yes we need to try to match the literature.
We should use the common name when possible / reasonable
It is known as zoster ophthalmicus rather than shingles ophthalmicus. I guess we could go with shingles of the eye?
Doc James (talk · contribs · email) 16:32, 5 July 2015 (UTC)
Zoster ophthalmicus is used in the literature, although I sense nowadays this is getting less commonly used. Not heard term shingles ophthalmicus before. Also zoster of the eye no good imo because it is not a precise equivalent of what we are trying to describe, I.e. involvement of the ophthalmic division of the trigeminal nerve. This might cause the lesions over the whole dermatome not just eye. Matthew Ferguson (talk) 06:56, 6 July 2015 (UTC)

I'd rather see this article WP:MOVEd to Shingles, but it's complicated because of Roof shingles and Shingle (disambiguation). When a common name is truly common (e.g., not narrowly regional), suitably formal in tone (e.g., not poop) and not ambiguous (e.g., not heart attack), then I'd rather have the common name. If normal, non-professional people are looking for information about Shingles, then I want them to know that they're definitely on the right page. WhatamIdoing (talk) 18:29, 5 July 2015 (UTC)

Yes agree. Shingles already redirects here so not to big of a deal to move it.Doc James (talk · contribs · email) 05:59, 6 July 2015 (UTC)
@WhatamIdoing:: As shingles redirects here, not to Shingle (disambiguation), do you see any problem in moving herpes zoster to shingles? I'm about to request that technical move if there is no opposition. Thanks. Fgnievinski (talk) 19:15, 6 July 2015 (UTC)
I have no objection. I do have some curiosity about whether any articles about architecture or building supplies accidentally redirect here. WhatamIdoing (talk) 00:39, 7 July 2015 (UTC)
Update: I have satisfied my curiosity, and fixed a dozen or so, all of which needed to link to roof shingle instead. WhatamIdoing (talk) 00:57, 7 July 2015 (UTC)

Merge Disseminated herpes zoster over here[edit]

Any cons? Fgnievinski (talk) 04:02, 5 July 2015 (UTC)

Good idea. Doc James (talk · contribs · email) 04:34, 5 July 2015 (UTC)
yep! Jytdog (talk) 04:47, 5 July 2015 (UTC)

Contagious?[edit]

I still feel the line in the lead about the vesicular fluid being capable of causing chicken pox in someone who is not a host to the virus needs to be clarified further. My understanding is that it is possible to transmit the virus in this manner, and potentially years later after the latent infection the other individual could still go on to develop shingles, just like anyone else infected with the virus. Matthew Ferguson (talk) 05:41, 5 July 2015 (UTC)

How about "Exposure to the virus in the blisters can cause chickenpox in someone who has not had it before but it will not trigger shingles" Doc James (talk · contribs · email) 08:37, 5 July 2015 (UTC)

Since I posted this Fgnievinski has ammended the wording and I think it's more precise now. Matthew Ferguson (talk) 08:46, 5 July 2015 (UTC)

Oral involvement[edit]

Extended content

The trigeminal nerve is the most commonly involved nerve, accounting for 18-22% of shingles cases.[1] The ophthalmic division of the trigeminal nerve is most commonly involved branch (zoster ophthalmicus).[2] Shingles may occur in the mouth if the maxillary or mandibular division of the trigemenial nerve is affected,[3] in which the rash may appear on the mucous membrane of the upper jaw (usually the palate, sometimes the gums of the upper teeth) or the lower jaw (tongue or gums of the lower teeth) respectively.[4] Oral involvement may occur alone or in combination with a rash on the skin over the cutaneous distribution of the same trigemnial branch.[3] As with shingles of the skin, the lesions tend to only involve one side, distinguishing it from other oral blistering conditions.[4] In the mouth, shingles appears initially as 1-4 mm opaque blisters (vesicles),[3] which break down quickly to leave ulcers that heal within 10-14 days.[4] The prodromal pain (before the rash) may be confused with toothache.[3] Sometimes this leads to unnecessary dental treatment.[4] Post herpetic neuralgia uncommonly is associated with shingles in the mouth.[4] Unusual complications may occur with intra-oral shingles that are not seen elsewhere. Due the close realtionship of blood vessels to nerves, the virus can easily spread to involve the blood vessels and compromise the blood supply, sometimes causing ischemic necrosis.[3] Therefore, oral involovment rarely causes complications such as osteonecrosis, tooth loss, periodontitis (gum disease), pulp calcification, pulp necrosis, periapical lesions and tooth developmental anomalies.[1]

  1. ^ a b Gupta, S; Sreenivasan, V; Patil, PB (2015). "Dental complications of herpes zoster: Two case reports and review of literature.". Indian journal of dental research : official publication of Indian Society for Dental Research. 26 (2): 214–9. doi:10.4103/0970-9290.159175. PMID 26096121. 
  2. ^ Samaranayake L (2 September 2011). Essential Microbiology for Dentistry (4th ed.). Elsevier Health Sciences. pp. 638–642. ISBN 0-7020-4695-7. 
  3. ^ a b c d e Chi AC; Damm DD; Neville BW; Allen CM, Bouquot J (11 June 2008). Oral and Maxillofacial Pathology. Elsevier Health Sciences. pp. 250–253. ISBN 978-1-4377-2197-3.  Cite uses deprecated parameter |coauthors= (help)
  4. ^ a b c d e Glick M (1 September 2014). Burket's oral medicine (12th ed.). coco. pp. 62–65. ISBN 978-1-60795-188-9. 

We now may contradict ourselves. "Zoster ophthalmicus involves the orbit of the eye and occurs in approximately 10% to 25% of cases." and "The trigeminal nerve is the most commonly involved nerve, accounting for 18-22% of shingles cases.[19]" — Preceding unsigned comment added by Doc James (talkcontribs) 16:27, 5 July 2015 (UTC)

hmm. Well we could decide which source is more reliable. 10-25% is supported by a 2002 Am Fam Physician review which gets these figures from a 1982 primary source. The 18-22% figure comes from a 2015 case report and review of lit from Indian journal of dental research which quotes two other scase report and review of lit from 2009 and 2010. We also have this textbook (ref 2 above) which says trigeminal involvment accounts for 15% of all cases. Matthew Ferguson (talk) 02:58, 7 July 2015 (UTC)

We also have this review [1] which says trgeminal zoster is 10-15%.

References

  1. ^ Klasser, GD; Ahmed, AS (2014). "How to manage acute herpes zoster affecting trigeminal nerves.". Journal (Canadian Dental Association). 80: e42. PMID 25437934. 

--Matthew Ferguson (talk) 06:28, 7 July 2015 (UTC)

Merge herpes zoster ophthalmicus here too?[edit]

This article could be condensed a lot since there is a lot of repetition. Matthew Ferguson (talk) 06:52, 7 July 2015 (UTC)

That's a good idea, although I wouldn't know what could be safely discarded and what should be kept. Fgnievinski (talk) 13:07, 7 July 2015 (UTC)

Intravenous Vitamin C for zoster?[edit]

There are a few old (but apparently unrefuted) studies on the efficacy of intravenous vitamin C for treatment of zoster. Before I go down that path, I'd like some corroboration from medical editors. Vitamins for treatment of anything seem to be eschewed in wikipedia. Sbalfour (talk) 18:51, 22 November 2016 (UTC)

Content is limited by what sources that comply with WP:MEDRS say. Jytdog (talk) 20:09, 22 November 2016 (UTC)

Herpes Zoster Oticus and Ramsey Hunt Syndrome[edit]

We should mention these here somewhere parallel to HV Ophthalmicus. RHS is not quite synonymous with HZO, as RHS implies involvement of the facial nerve in addition to the auditory nerve. Neither manifests until or unless you've already had chickenpox, so they're properly variants or complications of shingles.Sbalfour (talk) 19:58, 22 November 2016 (UTC)

Yup with a good ref should be added. Doc James (talk · contribs · email) 23:33, 23 November 2016 (UTC)