If I have a skin sample taken in oct of 2001 taken from a site on my
back and that block/slide/sample is now in my possession can I take it
to a pathologist and can he now determine within a reasonable degree
of medical certainty if i had shingles/herpes in oct of 2001.  Assume
that the sample is the only input that the pathologist can have

thanks'

paul

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Request for Question Clarification by pafalafa-ga on 21 Sep 2004 20:29 PDT

balloo-ga,

I doubt that anyone could give you a definitive answer to your
question, as much would depend on the actual sample itself.

There are several different types of diagnostic tests available for
shingles, with varying degrees of sensitivity and different
requirements as to what type of sample can be tested, and how recent
the sample material can be.

Even though Google Answers is not meant as a source of professional
medical advice (see the disclaimer at the page bottom), I can
certainly provide you an overview of the types of tests used to
diagnose shingles, and discuss the factors that would influence the
likelihood of a successful test from a sample that is several years
old.

But I couldn't tell you with certainty -- and I doubt anyone could,
whether a medical professional or not -- that a certain diagnosis
could or could not be made.

Let me know if you would like the diagnostic testing information as an
answer to your question.

pafalafa-ga

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Clarification of Question by balloo-ga on 22 Sep 2004 05:39 PDT

I have the sample in my possession      It was taken 10/2001

The answer to your question largely depends on the quality of the skin
sample. If the sample has been well preserved and is of the rash
itself, then a physician should be able to identify the distinctive
pattern of the rash and identify it as shingles.

I consulted a dermatologist and he confirmed that, as long as the
sample was well preserved and of the shingles rash in its infected
form (not after it had dried up) then a diagnosis could be made.

Supporting Information:

Medinfo: Shingles
http://www.medinfo.co.uk/conditions/shingles.html

"The pattern of the rash, in the form of blisters usually clinches the
diagnosis, but a sample of the fluid from the blisters, or of blood
can confirm it. It is unlikely that your doctor will need to do any
tests."

Shingles: Hope Through Research
http://www.ninds.nih.gov/health_and_medical/pubs/shingles.htm

"Like the shingles-causing virus, many other herpes viruses can take
refuge in the nervous system after an individual has suffered an
initial infection. These viruses may remain latent for years, then
travel down nerve cell fibers to cause a renewed infection."

http://www.ninds.nih.gov/health_and_medical/pubs/shingles.htm

"Because the shingles rash contains active virus particles however, a
person who has never had chickenpox can contract chickenpox by
exposure to the shingles rash."

What is Shingles?
http://www.ninds.nih.gov/health_and_medical/disorders/shingles_doc.htm

"Shingles is an infection caused by the varicella-zoster virus, which
is the virus that causes chickenpox. Shingles occurs in people who
have had chickenpox and represents a reactivation of the dormant
varicella-zoster virus. The disease generally affects the elderly,
although it occasionally occurs in younger and/or immunodeficient
individuals. The first sign is usually a tingling feeling, itchiness,
or stabbing pain on the skin. After a few days, a rash appears as a
band or patch of raised dots on the side of the trunk or face. The
rash develops into small, fluid-filled blisters which begin to dry out
and crust over within several days. When the rash is at its peak,
symptoms can range from mild itching to extreme and intense pain.
Contact with a person with shingles may cause chickenpox (but not
shingles) in someone who has never had chickenpox before."

Varicella Virus
http://www.bjck.com/fa/APPA-MAA.html#RTFToC13

"Varicella virus which causes chicken pox and herpes zoster (shingles)
is known to cause a significant thrombocytopenia or total bone marrow
suppression in patients with Fanconi anemia. Indeed, many FA patients
come to medical attention for the first time after the onset of
chicken pox.

Varicella virus is spread by direct contact or by airborne droplets.
The infectious period is from 24 hours before until six or seven days
after the appearance of vesicles. The scabs, after the vesicles have
dried, are not infectious.

The most important first step in prevention of chicken pox is to avoid
contact with patients with active disease. Patients who have been
exposed to varicella virus should receive, within 72 hours of
exposure, varicella zoster immune globulin (VZIG).

Patients who develop chicken pox or shingles, whether mild or severe,
should receive the antiviral agent acyclovir as early as possible.
Because of the poor absorption (about 15%) of the oral preparation,
the parenteral (IV) administration is more desirable. Patients with
milder disease could be switched to oral preparation three to four
days after the initiation of the parenteral preparation if there is no
further progression of the vesicles. Therapeutic decisions depend on
individual patients and are made by the physician in charge.

A new derivative of acyclovir known as famciclovir
(Famvir[[dieresis]]), with an absorption rate of 77% is currently
under consideration by the Food and Drug Administration. This drug may
obviate the need for parenteral preparations."

************************************************************

Additional Resources:

VZV Research Foundation [For Research on Varicella Zoster]
40 East 72nd Street
New York, NY 10021
vzv@vzvfoundation.org
http://www.vzvfoundation.org
Tel: 212-472- 3181 800-472-VIRUS (8478)
Fax: 212-861-7033 

Shingles Support Society (SSS)
http://www.onlinehealthresources.com/Conditions-and-Diseases/Skin-Disorders.html

The SSS supplies information on shingles and post-herpetic neuralgia
that can affect people, especially those over 60, after the shingles
itself has cleared up. The web pages include details of possible drug
therapy with dosages and references, written for the GP by a
consultant neurologist. Patients can send an SAE and (small) donation
for a 19 page information pack with self-help suggestions.
http://www.herpes.org.uk/shingles

Shingles: Hope Through Research
http://www.ninds.nih.gov/health_and_medical/pubs/shingles.htm

An informational booklet on shingles compiled by the National
Institute of Neurological Disorders and Stroke (NINDS).



Disclaimer:

This health-related material is provided for information purposes
only. Advice on the treatment or care of an individual patient should
be obtained through consultation with a physician who has examined
that patient or is familiar with that patient's medical history.

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Clarification of Answer by adiloren-ga on 01 Oct 2004 00:08 PDT

Google Search Strategy:

shingles, "skin sample"
shingles, diagnosis or diagnostics


Thank you for the question. I will be happy to clarify my response if necessary.

Regards,
Anthony (adiloren-ga)

not my specific area, but i would guess no.  as you are seeking to
diagnose a viral rash, i believe the diagnosis is made by attempting
to grow the virus from the specimen at the time of sample taking. by
now any virus would be gone.  my guess is that you might get a
'consistent with' or 'not consistent with' shingles diagnosis, but not
an adequate degree of certainty which you seek.