What is the pathogenesis of an acute herpes zoster infection?

What is the pathogenesis of an acute herpes zoster infection?

Acute herpes zoster (shingles) is an infection caused by the varicella zoster virus. This virus, the smallest of the double-stranded DNA herpes viruses, usually enters the body in childhood via the respiratory route and causes a varicella, or chickenpox, infection. When contracted as a child, this infection is usually a brief, benign illness; how-ever, it can be a serious illness if contracted as an adult. Chickenpox presents as a systemic viremia, followed by a rash on the face, thorax, arms, and legs. During this infec-tion, the virus gains access to the dorsal root ganglion, where it lays dormant. Later in life, the virus can become reactivated. Reactivation has been associated with aging, stress, malignancy, immunodeficiency, and steroid use, although in most cases of acute herpes zoster, no precise cause of reactivation can be noted. The reactivated virus replicates in the dorsal root ganglion, and spreads to the skin via the sensory nerves, causing acute herpes zoster, or shingles, infection.