I have been diagnosed with shingles (herpes zoster) The rash

Patient

Q: I have been diagnosed with shingles (herpes zoster). The rash came up 3 days ago. I was generally unwell for two weeks before with a sore throat, fatigue, headaches, cough. I also just moved areas for a new job so I was a bit run down. A friend came to stay last week who has herpes simplex. When she heard I have shingles, she told me she got an outbreak of her virus the same day as I got my rash and she is worried she has transmitted it to me and I have been misdiagnosed. We are only female friends but shared a piece of cale, also she used one of my towels and I used it the next day.
The only symptoms I have are the painful rash on my ribs and back in a linear pattern on my left side. I don't have any cold sores or genital symptoms. Her outbreaks are always genital sores. It seems a strange co-incidence though.
What do you think?

Doctor

A:   Hello,
Thanks for the query to asktehdoctor.com for an opinion,
As you have mentioned in your history that you have not been keeping well for last 2 weeks with sore throat, fatigue , headaches and cough, indicating that your general immunity was down and the stress of moving to a new area and environment further had its toil over the body defences. The causative agent for herpes zoster is the varicella zoster virus (VZV)—a double-stranded DNA virus related to the Herpes simplex virus.
Shingles (herpes zoster) is caused by the reactivation of a latent varicella zoster virus (VZV) infection, sometimes decades after the primary infection. It is not known what causes reactivation of the latent virus, which leads to the clinical manifestations of shingles, but reactivation is usually associated with conditions that depress the immune system such as immunosuppressive therapy, HIV infection and/or older age. Transmission of VZV can occur following direct contact with herpes zoster lesions.
In your case you had an exposure to herpes simplex virus HSV 1/2 which is unlikely to manifest as zoster but under a decreased immunity state a possible reactivation of the old VZ virus may occur . This has caused it to manifest in the rib region unilaterally as a confluent growth in form of fluid filled vesicles which affect one particular dermatome over the skin and are really painful.
It is suggested that you should be starting antiviral therapy sooner. This shall in form of oral and local application for a week. This shall help in reducing the incubation period , spread and course of the disease.
I hope i have answered your query in detail,
Wishing you speedy recovery,
Regards

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