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A painful skin rash with blisters in a limited area on one side of the body (left or right), often in a stripe.

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There is a vaccine to prevent shingles. Our objective was to evaluate the effectiveness and safety of the vaccine to prevent shingles in healthy older people.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 3, 2016

The aim of this Cochrane Review was to find out if valacyclovir performs better than acyclovir in the treatment of a painful itchy rash caused by the chickenpox virus (herpes zoster ophthalmicus). Cochrane researchers collected and analysed all relevant studies to answer this question and found one study.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 14, 2016

Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. It’s still not clear how it can be prevented or what the best treatment is.Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word "post-herpetic" means "post-herpes" because the pain arises after infection by the herpes zoster (shingles) virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.The main symptom of post-herpetic neuralgia is pain in the nerves (neuralgia). The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

We reviewed the evidence about the effect of antiviral medicines for preventing postherpetic neuralgia (PHN).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 6, 2014

If you've had chickenpox, you may get shingles. Both conditions are caused by the same virus. Having a weakened immune system – due to severe stress or old age, for instance – can increase the risk of developing this often very painful rash. It usually takes about two to four weeks for shingles to clear up.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Postherpetic neuralgia is a painful condition that occurs in patients after they have been affected by a recurrence of the herpes zoster virus (shingles). The pain may persist for years and is often difficult to treat. Herpes zoster virus vaccination is a possible new approach to prevent herpes zoster and postherpetic neuralgia. We identified a single high quality trial with a total of 38,546 participants, comparing vaccination with placebo. It found a significant reduction of herpes zoster, but did not provide enough direct evidence to draw any conclusion about whether the vaccine is effective in preventing postherpetic neuralgia beyond its effect on reducing herpes zoster. Non‐serious adverse events were more common among vaccine recipients than placebo recipients, but serious ones were rare. More well designed and specialised trials of vaccination for preventing postherpetic neuralgia are required.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 16, 2011

It seems logical that antiviral drugs might help patients with a herpes virus infection of the ear producing facial weakness (a condition known as 'Ramsay Hunt syndrome'). These drugs often help similar viral infections elsewhere in the body. However, trials that might address this issue have not been done and there is therefore some uncertainty about their usefulness. Since patients can experience side‐effects when taking these drugs, the risks of these have to be balanced with the unknown prospect of benefit when considering whether to use them in Ramsay Hunt syndrome.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 8, 2008

Ramsay Hunt syndrome (also known as herpes zoster oticus) consists of weakness of the face due to infection with the varicella zoster virus.  Five cases arise per 100,000 of the population per year in the US.  It is more common among those over 60 and rare in children. Other symptoms may include severe ear pain and small blisters on the outer ear or in the mouth.  Prompt diagnosis and treatment (ideally within 72 hours of the onset of symptoms) are crucial to secure the best outcomes. In cases where treatment has been started within this time period, facial weakness recovers in up to 75% of patients. Standard treatment is with antiviral therapy (most commonly acyclovir). Corticosteroids are known for their anti‐inflammatory properties and are commonly used together with antivirals to reduce the inflammation in the facial nerve.  This is thought to be the cause of the facial weakness.  The aim of the review was to see if corticosteroids, used at the same time as antiviral drugs, improved outcomes in patients with Ramsay Hunt syndrome.  However the review found no trials matching the inclusion criteria, and no conclusions can be drawn about the effectiveness of using corticosteroids in this way.   It is recommended that high‐quality randomised controlled trials be undertaken to address this issue.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 16, 2008

Chickenpox is highly contagious. If you are not vaccinated and have never had chickenpox, contact with someone who has it will almost always lead to infection. Early vaccination and being careful around those who have chickenpox are the most important precautions you can take.Chickenpox is caused by the varicella-zoster virus, which is one of the herpes viruses. The German Standing Committee on Vaccination (STIKO) at the Robert Koch Institute recommends being vaccinated to lower your chances of infection. If you or someone in your family gets chickenpox there are several things you can do to avoid spreading it to others.Most importantly, people who have chickenpox should avoid contact with anyone who hasn’t had it and with people who have a greater risk of developing more severe symptoms. This especially includes people with a weakened immune system, newborn babies, and non-vaccinated adults. The virus can harm unborn children during pregnancy, and can be life-threatening for newborns. Generally speaking, though, chickenpox rarely has any serious consequences in children who are otherwise healthy. But it can be unpleasant.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

The typical signs of chickenpox are a very itchy skin rash with red blisters and a mild fever. This contagious viral infection mainly affects preschool and school-age children between the ages of two and ten. Chickenpox is unpleasant, but it rarely leads to any serious complications in otherwise healthy children.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

We reviewed the evidence about the effect of antiviral therapy alone or in combination with any other therapy, on Bell's palsy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 9, 2015

Outer ear infections are often referred to as “swimmer’s ear.” The ear may become blocked, feel uncomfortable or hurt. Swimmer’s ear is usually caused by bacteria or fungi. The risk is higher for people who swim a lot, children, and people with hearing aids.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 30, 2017

Postherpetic neuralgia is a painful condition that is one of the most common complications of an acute herpes zoster infection. Herpes zoster presents as a localised rash resembling localised chicken pox, often called 'shingles'. Postherpetic neuralgia may persist lifelong once it occurs and has major implications for quality of life and use of healthcare resources. Corticosteroids have a potent anti‐inflammatory action, which it has been suggested might minimise nerve damage and thereby relieve or prevent the pain experienced by people suffering from this condition. Five trials were identified from a systematic search of the literature which were of high enough quality to be included in the review. These trials involved 787 participants in total. We were able to combine the results from two trials (114 participants) and there was no significant difference between the corticosteroid and control groups in the presence of postherpetic neuralgia six months after the onset of the acute herpetic rash. Two of the three other included trials reported results at less than one month, so these participants did not fulfil the current criteria for a diagnosis of postherpetic neuralgia. The last trial reported results in a format unsuitable for meta‐analysis. There were no significant differences in serious or non‐serious adverse events between the corticosteroids and placebo groups. There was also no significant difference between the treatment groups and placebo groups in other secondary outcome analyses and subgroup analyses. It can be concluded that, based on moderate quality evidence, corticosteroids are not effective in preventing postherpetic neuralgia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 28, 2013

This review assessed how useful the varicella (also known as chickenpox) vaccine is in preventing chickenpox when given to children or adults who have never been immunised or previously had chickenpox, but who receive the vaccine within a short time following exposure to a person infectious with chickenpox. Varicella is a highly contagious viral infection characterised by a widespread pustular rash, fever and generally feeling unwell. We identified three trials involving 110 healthy children who were siblings of household contacts.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 23, 2014

Expert-reviewed information summary about the treatment of adult Hodgkin lymphoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 20, 2017

Viral infections cause significant disease and even death in patients with blood cancers. In the current systematic review of randomized controlled trials (RCTs) we aimed to evaluate the efficacy and safety of viral vaccines in these patients. The pre‐defined primary outcome was incidence of the infection concerned. Secondary outcomes were mortality due to the viral infection, all‐cause mortality, incidence of complications, incidence of severe viral infection, hospitalization rate, in vitro immune response and frequency of adverse effects. Eight RCTs were included. They evaluated heat‐inactivated varicella zoster virus (VZV) vaccine (two trials), influenza vaccines (five trials) and inactivated poliovirus vaccine (one trial). There were no RCTs on other viral vaccines (hepatitis A, hepatitis B, measles, mumps, rubella). Only the two trials on VZV vaccine reported our pre‐defined primary outcome. All trials reported some of the pre‐defined secondary outcomes. We found that inactivated VZV vaccine might reduce the severity of herpes zoster when given before and after stem cell transplant in adults with lymphoma or leukemia. Inactivated influenza vaccine might reduce upper and lower respiratory infections and hospitalization in adults with multiple myeloma who are undergoing chemotherapy, or children with leukemia or lymphoma within two years post‐chemotherapy. However, the quality of evidence is not high. Local adverse effects occur frequently with the vaccines, although serious adverse effects appear uncommon. Further high‐quality RCTs are needed to clarify the benefits and optimal regimens of viral vaccines for patients with blood cancers.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 16, 2011

This review included 31 patients taking cyclophosphamide and 39 patients taking placebo. Patients taking cyclophosphamide had improved tender and swollen joint scores. Patients receiving placebo were six times more likely to discontinue treatment because of lack of treatment effect than patients receiving cyclophosphamide. Withdrawals from adverse reactions were higher in the cyclophosphamide group. Side effects from cyclophosphamide included hemorrhagic cystitis, nausea, vomiting, leucopenia, thrombocytopenia, alopecia, amenorrhea and herpes zoster infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 23, 2000

Cytomegalovirus (CMV; a herpes virus) is the most common type of virus detected in people who have received solid organ transplants (kidney, heart, liver, lung and pancreas). CMV disease is a major cause of illness and death during the first six to 12 months after transplantation. Two main strategies to prevent CMV disease have been adopted: protection and prevention (prophylaxis) of viral infections for all organ recipients using antiviral drugs, or 'pre‐emptive therapy' of organ recipients, who develop evidence of CMV infection during routine screening.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 28, 2013

How does fingolimod compare in multiple sclerosis?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: November 30, 2011

Neuropathic pain is pain coming from damaged nerves. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, or cut, or arthritic knee). Neuropathic pain is treated by different medicines than pain from damaged tissue. Medicines like paracetamol or ibuprofen are usually not effective in neuropathic pain, while medicines that are sometimes used to treat epilepsy or depression can be very effective in some people with neuropathic pain. Other possible treatments include the use of local anaesthetic applied to the skin.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 24, 2014

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