Herpes zoster
Herpes zoster is a disease more commonly known as “shingles shingles”. The disease affects the skin, the human nervous system, the causative agent is the herpes virus. Characteristic symptoms of herpes zoster are spots that gradually turn into vesicles, and then the phenomenon of residual hyperpigmentation occurs.
The content of the article:
Etiology of the disease
Epidemiology of herpes zoster
Pathogenesis of herpes zoster
Herpes Zoster Clinic
Differential diagnosis of herpes zoster
Treatment of herpes zoster
Herpes zoster
The treatment of this disease can be carried out by a dermatologist or a neurologist. Typical is therapy with the use of drugs “Acyclovir” or “Zovirax”. In addition, a patient with shingles is shown treatment of the symptoms of the disease, so the affected areas of the skin are treated with aseptic drugs in combination with additional physiotherapy procedures.
Etiology of the disease
Herpes zoster, like chickenpox, occurs due to exposure to the pathogen virus. It belongs to the Herpesviridae family and has several characteristic features. Firstly, this virus is not capable of long-term life in the external environment. Harmful to it are the sun’s rays, aseptic, antibacterial drugs, cleaning and detergents. Secondly, this causative agent of the disease does not tolerate high temperatures.
However, the herpes zoster virus is resistant to low temperature, it can preserve and continue its life cycle for a long time, as well as be subjected to repeated freezing.
Epidemiology of herpes zoster
Due to its properties described in the section above, it can be said that herpes zoster occurs as individual cases, the peak of the disease, respectively, falls on the cold season. This is not the most common disease for the population: for every 100 thousand people, from 12 to 15 cases of the disease are registered.
Having considered the etiology, it can be argued that herpes zoster is more common for older people who have previously suffered from chickenpox. The body of these patients did not develop immunity to this disease, so they were repeatedly infected with the pathogen virus.
In addition, it is noted that children who have previously had contact with chickenpox patients are more susceptible to herpes zoster. The connection of these diseases was noted in 1988, and since then the pattern of infection has been confirmed by doctors.
Pathogenesis of herpes zoster
Herpes zoster is classified as an infection that occurs a second time in those patients who have a history of chickenpox. Chickenpox at the same time could occur both clinically and latently, it does not matter. The virus in both cases can be in the body for a long time, most often it is concentrated in the ganglia of the cranial nerves and spinal. Re-infection occurs by activating this virus, it can happen for many reasons. It is not known for certain which factors influence the activation of the virus, but doctors with 100% probability declare a key aspect of the reactivation of the virus: the weakening of cellular immunity.
The list of known factors influencing the activation of the virus includes the following:
state of stress, nervous tension;
injuries, bruises, concussions;
hypothermia;
diseases of the somatic system;
viral and infectious diseases;
oncological diseases;
problems with the circulatory system;
taking chemical or hormonal drugs;
the age aspect.
Anatomical pathology includes a wide range of manifestations: changes caused by inflammation in the spinal ganglia, adjacent skin, posterior and anterior horns of gray matter, spinal cord roots, soft meninges.
Herpes Zoster Clinic
Activation of the virus, which retains its vital activity, leads to the manifestation of signs characteristic of herpes zoster. Symptoms are gradually revealed: the disease begins with an increase in temperature, causing the patient to have a state of general malaise, chills and weakness are observed, dyspeptic disorders are manifested.
Peripheral nerve trunks will detect symptoms of itching and burning that occur during the disease. It is also possible to feel scabies in those places where rashes will appear later.
The above-mentioned signs of herpes zoster are called subjective, since they manifest themselves over different periods of time, with different activity and intensity, in addition, some symptoms in patients may not appear at all.
The initial period of herpes zoster lasts in different ways: adults experience it for four days, children go through it faster. Then comes the next stage of herpes zoster development, during which the temperature rises sharply and is accompanied by headache, lack of appetite, muscle pain and other symptoms of intoxication of the body.
In parallel with this symptom, a rash appears, directed along the course of one of the spinal ganglia. The rash looks like pink spots with an average diameter of two to five millimeters. Individual rashes are not prone to fusion.
After the manifestation of the rash symptom, vesicles appear on the body during the day. Their contents are serous matter, the grouping of vesicles is dense, the edges are uneven. Rashes are accompanied by edema and hyperemia at the place of appearance.
There may be an increase and a feeling of soreness in the lymph nodes, but the activity and intensity of the manifestation of this symptom depend on the state of the patient’s immunity, the severity of the disease and the general history.
In children at this stage, there is a possible inflammation of the respiratory tract. Such an accompanying infection, of course, affects the overall course and course of the disease, and even pharyngitis or rhinitis can provoke various complications.
At the same time, symptoms characteristic of different stages of the development of the disease may appear, especially with regard to the nature of rashes. Spots, vesicles, and areas of hyperpigmentation may appear on the skin. Usually, after this, there comes a stage when the swelling of the vesicles subsides, and the fluid contained in them becomes cloudy. Gradually, this type of rash dries up, the vesicles disappear, leaving sulfur crusts in their place.
After the sulfur crusts fall off from the skin, a trace may remain in their place as a result of a slight pigmentation of the skin. This stage of the disease indicates recovery: the patient’s body temperature decreases, along with the symptoms of intoxication and the intensity of other manifestations of the disease go away. Usually, this stage occurs after three weeks of the course of the disease, by the end of this period, the patient is fully recovered.
There are several forms that herpes zoster has. The treatment of the disease depends on the symptoms and anamnesis of the patient. Thus, distinguish:
generalized form;
abortive form;
bullous form.
The generalized form of herpes zoster is often diagnosed as an attached chickenpox. This is due to complex symptoms, including rashes not only along the nerve trunks, but also on the mucous membranes and other areas of the skin. With a generalized form of herpes zoster, as well as in the case when any form of this disease lasts longer than twenty-one days, an additional examination is prescribed by an oncologist, or the patient is checked for the presence of immunodeficiency.
The abortive form of herpes zoster is characterized by symptoms of erythematous rash along the nerve trunks. This type of rash quickly disappears from the skin, and is not replaced by serous vesicles. It is worth noting that the general condition of the patient remains stable and normal, other symptoms do not manifest and do not worsen the quality of his life.
The bullous form of herpes zoster is characterized by the presence of the largest vesicles. They tend to merge and form large bubbles filled with serous contents. Often, when vesicles merge, blood vessels are damaged, which makes the formed blisters hemorrhagic. If an infection gets into such a neoplasm, the serous substance will fester. Vesicles prone to fusion, even being purulent, still tend to unite, which leads to the appearance of new infection sites. After the rashes dry out, dark areas remain on the patient’s body — necrotic scabs.
There are several severity classes by which herpes zoster is determined. The reason for the subdivision is the localization of rashes. For example, if they are located near or along the course of the facial nerve, then there is every reason to attach a disease with symptoms of “neuralgic lesions”, “lesions of the mucous membrane, cornea, eyelids”.
The duration of the course of the disease depends on the form in which it manifests itself in the patient. The acute form lasts two or three weeks, the complicated course takes more than a month.
Differential diagnosis of herpes zoster
When contacting a doctor, it should be expected that the examination process will take quite a long time, since it is necessary to differentiate another disease similar to herpes zoster. When the correct diagnosis is made, the specialist will understand how to treat this disease.
Diagnostics is carried out, differentiating the disease from trigeminal neuralgia, appendicitis, pleurisy, cholelithiasis. These differences are necessary at the primary stage of the disease.
In the event that the location of the rash does not coincide with the course of the nerve trunks, then it is necessary to distinguish between chickenpox and a simple form of herpes.
Bullous herpes zoster is distinguished from diabetes mellitus, immunodeficiency, erysipelas of the skin.
Treatment of herpes zoster
Etiotropic therapy is used: inhibitors of viral DNA synthesis. Acyclovir, intravenous drip of virolex are prescribed, a daily dose is set, applied every eight hours. In most cases, the period of such therapy is about five days.
Pathogenetic therapy: administration of the drug “Kurantil”. This medication is used to stop platelet aggregation. In addition, at this stage of treatment, Furosemide is also used, which performs the function of dehydration. Homolytic immunoglobulin, additionally prescribed in the complex of pathogenetic therapy, activates immunogenesis.
Symptomatic therapy: it is prescribed individually, depending on how the disease proceeds and how painful the symptoms are. A wide range of medications used here includes painkillers, antipyretics, sedatives, antidepressants.
Local therapy: rashes and vesicles are treated with a solution of brilliant green, dermatol ointment. Hardware techniques include ultraviolet irradiation, quartz, laser therapy.
To eliminate the symptoms of intoxication, manifested at all stages of the disease, special therapy is used. A formed diuresis is prescribed, which helps to reduce the manifestations of intoxication of the body.
If symptoms of herpes zoster appear, it is necessary to consult a doctor as soon as possible. This is especially important for those patients who have a history of diseases that reactivate the virus, requiring a differential diagnosis. It is necessary to immediately consult a doctor and those who are experiencing stress or nervous shocks against the background of symptoms.
