{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:09:48Z","timestamp":1787008188590,"version":"build-2736575974"},"reference-count":11,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Medical Acupuncture"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic toggle=\"yes\">Varicella-zoster<\/jats:italic>\n                      virus (VZV) remains dormant in the dorsal root ganglia and can become reactive later in a person's life. Factors such as stress, trauma, chronic disease, systemic illness, immune disorders, and age-related decline in host immunologic responses can potentially incite reactivation. Activation of VZV resulting in shingles following acupuncture has been reported in the literature previously, and some mechanisms have been proposed for this observation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>\n                      A patient with a history of total thyroidectomy for thyroid cancer presented with chronic neck pain. She was clinically and biochemically in a euthyroid state and on thyroid replacement therapy. She had a history of chickenpox, at age 13, and seasonal allergies. After her first acupuncture session, she received an allergy shot for her seasonal allergies. A day after the procedure, she developed a vesicular rash and was subsequently diagnosed with acute\n                      <jats:italic toggle=\"yes\">Herpes zoster<\/jats:italic>\n                      . Subsequent acupuncture was withheld following this event. She received acyclovir and applied topical\n                      <jats:italic toggle=\"yes\">Aloe vera<\/jats:italic>\n                      to the cutaneous lesions, and developed mild scarring, but did not experience postherpetic neuralgia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Acupuncture is a minor trauma that can predispose a patient to reactivation of VZV and shingles in the setting of immune activation with allergen immunotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/acu.2020.1521","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T10:14:42Z","timestamp":1640254482000},"page":"443-446","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Acupuncture, Shingles, and Allergen Immunotherapy"],"prefix":"10.1177","volume":"33","author":[{"given":"David","family":"McMahon","sequence":"first","affiliation":[{"name":"Integrative Medicine Program and University of Florida Health, Gainsville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushma","family":"Kadiyala","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, University of Florida Health, Gainsville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene M.","family":"Estores","sequence":"additional","affiliation":[{"name":"Integrative Medicine Program and University of Florida Health, Gainsville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268808000678"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-004833"},{"key":"e_1_3_5_4_2","author":"Lin KC","year":"2009","unstructured":"Lin KC, , Wang CC, , Wang KY, , Liao YC, , Kuo JR. Reactivation of herpes zoster along the trigeminal nerve with intractable pain after facial trauma: A case report and literature review. BMJ Case Rep. 2009;2009:bcr07.2008.0525.","journal-title":"BMJ Case Rep"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2012.06.020"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/acu.2017.29062.lit"},{"key":"e_1_3_5_7_2","first-page":"1310","article-title":"Letter: Activation of cutaneous herpes by acupuncture","volume":"290","author":"Chang TW","year":"1974","unstructured":"Chang TW. Letter: Activation of cutaneous herpes by acupuncture. N Engl J Med. 1974; 290:1310.","journal-title":"N Engl J Med"},{"key":"e_1_3_5_8_2","author":"Kewish SA.","unstructured":"Kewish SA. A case of shingles following auricular acupuncture. J Am Board Fam Med. 2017:30(4):552\u2013555.","journal-title":"J Am Board Fam Med"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis937"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiy403"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40413-015-0063-2"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2010.03.010"}],"container-title":["Medical Acupuncture"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/acu.2020.1521","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/acu.2020.1521","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/acu.2020.1521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:06:42Z","timestamp":1777392402000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/acu.2020.1521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1089\/acu.2020.1521"],"URL":"https:\/\/doi.org\/10.1089\/acu.2020.1521","relation":{},"ISSN":["1933-6586","1933-6594"],"issn-type":[{"value":"1933-6586","type":"print"},{"value":"1933-6594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]}}}