Very frequent Shingles outbreaks?

Patient: Good evening,In 2007 (age 23) I got a cluster of painful serous-filled blisters on my chin. My lymph nodes were also very swollen and tender. I went to the ER and several doctors looked at me and all agreed that I had Shingles. The also agreed that is was very unusual to have it on my chin. I believe they did a culture and called me to confirm that it was Zoster, but I can’t remember 100% if they did or not. They gave me Acyclovir and soon after it oozed, scabbed, and healed. Now, I am 30 and have gotten it 3-4 times a year since then and more and more frequently (2 times last month).A year ago, I went to the doctor because I always feel tired, I have headaches all the time, and other bowl issues. They did a blood test for thyroid issues and that came back negative. I have also had an endoscopy procedure to test for Celiacs and that was negative as well. They guess I have IBS with chronic constipation. Anyways, I just figured that if I had something serious, it would show up on the blood tests. Do they do a full blood count on those? I have no idea.I have been in the medical field for a long time now so I’d like to think that I have SOME medical knowledge of diseases:). I know that most people get shingles once, rarely twice, and most are 55 or older. The fact that I have outbreaks so often, and more than 20, is a big red flag to me. Is there some sort of immune disorder underneath it all? Is there anything specific I should get tested for? I do want to get it re-cultured the next time I get it just to make sure it is Shingles, although I’m fairly certain they did that in the ER back in 2007. Also, if it is Shingles, can I be vaccinated at my age? Any advice would be GREAT! Sorry for the novel 🙂

Symptoms: Painful, oozing blisters on my chin. Diagnosed as Shingles. I have had more than 20 outbreaks in 7 years, all but 2 were slightly on the right side of my chin. The other 2 were on the left. Swollen lymph nodes, fever, etc.

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Doctor: Thank you for your question.It would be rare to have shingles that many times in such a short period of time. It wo uld require a severe impairment of the immune system (HIV, transplant patients, and chemotherapy patients). The history, pattern and frequency suggest it is more likely a herpes outbreak.Herpes is the same virus that causes cold sores.When doctors are unsure if it is herpes or shingles, a culture is done at the time of outbreak to determine the cause.The treatment of a herpes outbreak and shingles outbreak is nearly identical (1 to7 days of antivirals as determined by your doctor) so sometimes the diagnosis is only important from a curiosity standpoint.Vaccination would not be helpful to you at this stage.

Comments / Follow Ups

Doctor: Thank you for your question.
It would be rare to have shingles that many times in such a short period of time. It would require a severe impairment of the immune system (HIV, transplant patients, and chemotherapy patients). The history, pattern and frequency suggest it is more likely a herpes outbreak.
Herpes is the same virus that causes cold sores.
When doctors are unsure if it is herpes or shingles, a culture is done at the time of outbreak to determine the cause.
The treatment of a herpes outbreak and shingles outbreak is nearly identical (1 to7 days of antivirals as determined by your doctor) so sometimes the diagnosis is only important from a curiosity standpoint.
Vaccination would not be helpful to you at this stage.

Patient: Thanks for your answr. I am aware of the different types of herpes and their differences. I did confirm what a culture was done and it is zoster. I guess I was more wanting to know if there could be a specific underlying immune issue instead of diagnosing the blisters. Also, I was hoping for an explanation of why the vaccine isn’t an option….or is it just becuase you thought it shingles? Anyway. Thanks for your time.

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