Herpes zoster (shingles)

Rembrandt van Rijn
July 15, 1606, Leiden - October 14, 1669, Amsterdam, Netherlands

♦ Rembrandts mother 1639 ♦
Rembrandt painted his mother a year before she died.
She is leaning on a walking stick and wearing a Jewish prayer cap, representing the prophetess Anna, aged 84, as described in Luke 2:36-38:
'There was also a prophetess, Anna, the daughter of Phanuel, of the tribe of Asher.
She had lived a long life: after her maidenhood, she had lived with her husband for seven years and had been a widow for about 84 years. She never left the sanctuary, fasting and praying, worshipping God day and night. Now her hour was approaching.
She thanks God and speaks to all who await the redemption of Jerusalem.

♦ Diagnosis
Significant symptoms: Scar on the left side of the face, retracted lower eyelid on the left, atrophied jaw muscles, toothless mouth, bent posture of the head. (Pain?)
Secundary symptoms: 84-year-old woman, devout woman, richly dressed.ekleed.
Clinical diagnosis: Herpes zoster (shingles), postherpetic neuralgia, torticollis (wry neck due to neck spasm).

♦ Definition: Herpes zoster (shingles)
Herpes is an acute inflammation of the skin or mucous membrane, characterized by the development of a group of blisters on an inflamed area.
Herpes zoster is a type of herpes in which the lesions follow the course of a nerve.
As a rule, it only occurs on one side of the body. The disease usually breaks out along the line of an intercostal nerve, but in principle it can occur with any nerve.
The bursting of the vesicles is often preceded and may also be followed by severe nerve pain, known as postherpetic neuralgia.
It is a systemic infection caused by a virus.
It can be serious in elderly or frail individuals.
The disease is also known as shingles or (in Flanders) zona.

♦ Definition: torticollis
Tilted neck: a contraction of the sternocleidomastoid muscle, usually on one side, resulting in an abnormal position of the head.

♦ Discussion
Viral invasion of the posterior nerve ganglia causes pain, followed by a rash along the course of the affected nerve.
This is the same virus that causes varicella (chickenpox) and indicates a reactivation of a previous infection with the chickenpox virus that was dormant in the body.

Reactivation occurs when the immune response in the body is suppressed by another disease, by medications (such as corticosteroids and immunosuppressants), or by old age.
The pain of herpes zoster usually subsides as the rash clears up, but in rare cases, especially in older people, it can be followed by persistent postherpetic neuralgia that can last for months or even years.
Partial muscle wasting is relatively rare.

Source: Jan Dequeker

Jan Dequeker
The artist and the doctor

Photos
Wikimedia.org

- Rembrandt's mother
https://artivity.gr/p/4148/portreto-miteras-remprant-1-leptomereia-remprant-harmensoon-pinakes