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Shingles: Symptoms and Treatment

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Shingles Shingles is a viral infectious disease characterized by grouped vesicular skin rashes on the erythematous edematous background. As a rule, they are limited, located on one side of the body along the branches of the dermal nerve, and in some cases may be accompanied by prolonged neuralgia.

The causative agent of this disease is a virus from the Herpes viridae family. It is capable of causing two pathologies completely different in the clinical picture: chicken pox (chickenpox) and herpes zoster (lichen). This virus is a nucleotide with an oval membrane, reaching a diameter of 30-50 nm. The most optimal temperature for its development and reproduction is the temperature of 37 degrees Celsius.

Herpes zoster affects epithelial and connective tissue skin cells, as well as cells of the central and peripheral nervous system.

It is very sensitive and quickly dies under the influence of high temperatures and UV radiation, is unstable to disinfectants and is not able to exist in the external environment. At the same time, the causative agent of shingles tolerates low temperatures well and is able to maintain its viability even after freezing.



Mechanism of disease development

To date, the mechanism of reactivation of the varicella-zoster virus is not known to science. Many authors suggest that after a patient in childhood gets chickenpox, the herpes zoster virus, penetrating into the nerve cells, goes into a latent state and does not manifest itself. And only decades later, due to the violation of several parts of cellular immunity, it can be activated, leave the nerve cells and move along their axons. Then, when the virus reaches the end of the nerve, it provokes the development of an infectious process.

However, to explain in detail how the varicella-zoster virus goes into a “sleeping” state, scientists are still not able to.

Causes of shingles

Most often, the disease affects older people, as well as patients diagnosed with leukemia or Hodgkin's disease. It can also be detected in persons undergoing chemotherapy and in those who have taken corticosteroids and immunosuppressants for a long time.

In childhood, herpes zoster occurs as a result of contact with a sick person.

Risk factors that trigger the development of this pathology include pneumonia, tuberculosis , syphilis , meningitis, alcohol poisoning, arsenic or mercury, sepsis, influenza, cancer metastases and HIV infection.

в клинической практике наблюдались случаи, когда ветрянка и опоясывающий лишай у пациента развивались одновременно. Note: In clinical practice, there were cases when the patient developed chickenpox and shingles in the patient at the same time.

Ways of transmitting a viral infection:

  1. Airborne.
  2. Contact and household.
  3. Transplacental.



Shingles: Symptoms

Shingles symptoms In the early stages of the disease, patients complain of discomfort. Further, the body temperature rises, and also appear different intensity of pain - harbingers of rashes. As a rule, along the branches of the affected skin nerve, small nodules form on the edematous hyperemic skin. After three or four days, they are reborn into tight bubbles the size of a pinhead. Through their tight tire one can see liquid serous contents, which after 3-4 days grow turbid.

After seven days, the bubbles dry out and look like yellow-brown crusts. They are rejected after one or one and a half weeks, and in their place the pigmentation (or depigmentation) that takes place over time.

It should be noted that for this disease is characterized by unilateral located rash, presented in the form of individual lesions along the branches of the sensory nerve. Between them there are healthy skin areas, as well as quite painful sensations that may be common or localized.

Sometimes patients complain of dull, or vice versa, sharp and burning pain, varying in duration. Most often, the pain persists even when the rash disappears completely. Regional lymph nodes in patients with herpes zoster are enlarged and also quite painful.

Patients who have had shingles develop strong immunity, and therefore there is no recurrence.

Most often, outbreaks of the disease are recorded in the fall and spring. In the mild form of the pathological process, the skin nodules do not transform into vesicles. However, in severe form of the disease, vesicular vesicles are transformed into ulcers, which after a while begin to ulcerate. In this case, herpes zoster acquires a protracted nature and lasts up to one and a half months.

при развитии ганглионитов поясничных и грудных узлов поражаются чревные нервы, пограничные симпатические узлы и солнечное сплетение. Note: the development of the lumbar and thoracic ganglionites leads to celiac nerves, borderline sympathetic ganglia and the solar plexus. As a result, the work of the digestive tract is disturbed, urinary retention and other equally serious disorders are noted.

Most often, the rash with shingles is localized on the forehead and in the face, as well as on the back of the head, neck and torso. In this case, patients may develop complications from the nervous system and organs of vision.

Clinical types of the disease

Idiopathic spontaneous form of herpes zoster

The cause of this form of pathology is not known to science. Scientists suggest that the disease develops as a result of reactivation of the virus due to the influence of certain adverse factors. These can be injuries and intoxications, bacterial and viral respiratory infections and somatic diseases. At the same time, atypical forms of pathology are known to clinicians.

Necrotizing or gangrenous shingles

With the development of this form of the pathological process, pustules and vesicles with serous contents open up, forming painful ulcers. Initially, the ulcers are arranged in small groups, which are separated by sections of healthy skin. Then they merge. Skin ulcerations become deep, with a small-palestine outline and characteristic gangrenous decay. After the healing process, scars located in groups with pronounced depigmentation remain on the body. In this case, the disease lasts over three months and all this time, patients complain of severe pain.

Abortive form of herpes zoster

As a rule, in this form of pathology, one small lesion develops. Patients practically do not complain of pain, itching and burning, and after three or four days there is a cessation of the development of skin elements.

Generalized (disseminated) shingles

This form of the disease affects elderly patients suffering from atherosclerosis, Hodgkin's disease, or diabetes mellitus. It is characterized by various rashes in different parts of the skin and mucous membrane. Generalized herpes zoster also proceeds without subjective sensations, and the skin elements are very similar to the elements of chicken pox. After 10-15 days there is a regression of the disease, in which fever, weakness and malaise may occur.

Hemorrhagic form of shingles

In this case, the vesicles formed in the patient, reaching sizes from 1 to 5 mm, are filled with serous contents in the early stages of the disease. However, after 3-5 days it acquires hemorrhagic red-brown staining.

Ulcerative shingles

With the development of this form of the pathological process formed bubbles begin to ulcerate. Then dense yellowy-brown or brown crusts form on their surface. The disease lasts a long time and is very difficult.

Bullous Shingles

The bullous form is a type of disease in which skin elements that are closely adjacent to each other merge and form one continuous blister. After it dries, a scab of necrotic tissue remains in the form of a large dark spot.

Shingles and pregnancy

The occurrence of shingles in pregnant women is a rather alarming signal. Often, it is pregnancy that becomes a predisposing factor, provoking the reactivation of the herpes zoster virus, which has been “dormant” for a long time in the body of the future mother.

Very often, this disease causes intrauterine infection. As a result, children are born with signs of severe damage to the nervous system or brain. Congenital blindness or deafness can be diagnosed in newborns. Also, the probability of miscarriage, stillbirth or death of a newborn is not excluded.

What is dangerous herpes zoster?

Fortunately, most patients who have herpes zoster are diagnosed recover after a short time. However, in some cases, some neuralgic symptoms may remain for several months (and even years), which mainly depend on the location of the rash. In the event of herpes zoster on the face or on the head, it can affect the nerves that are located in the same area under the skin. As a result, the patient develops a strong pain syndrome. However, sometimes the disease can provoke damage to the facial nerves or the cornea of ​​the eye, one-sided facial paralysis and hearing impairment.

In severe cases, herpes zoster causes encephalitis, meningitis, acute myelopathy, and even malignant neoplasms.

Diagnosis of Shingles

Shingles photo As a rule, diagnosis is made on the basis of the clinical picture, and therefore laboratory diagnosis is not carried out. In some cases, the patient may be taken for examination pieces of affected tissue or the contents of the vesicles. However, it is mandatory for people with suspected development of herpes zoster to have a blood test for HIV, as skin manifestations may be the only marker of AIDS.

It is mandatory that the patient undergoes a differential diagnosis of herpes, contact dermatitis, impetigo, true eczema and vesicular syphilis during the bubble period.

It should be noted that in case of gangliotegmental form of herpes zoster, diagnosis is not difficult. However, at the earliest stages of the disease in the diagnostic process errors may occur. With the development of intoxication, fever and severe pain, depending on their location, the patient can be diagnosed with heart attack, angina, hepatic or renal colic. Therefore, in such cases, competent professionals recommend to undergo special rapid methods of serological diagnosis. They are similar to those used to detect the herpes simplex virus or chicken pox.

Shingles treatment

Patients diagnosed with severe herpes zoster are hospitalized without fail in an infectious disease hospital. This is because for people who do not have immunity to the herpes zoster virus, they are sources of infection.

In the case when the patient is treated on an outpatient basis, he is prescribed symptomatic therapy aimed at stopping the pain syndrome, as well as receiving antiviral drugs that prevent secondary infection through the serous contents of the vesicles.

этиотропное лечение предусматривает применение препаратов местного и системного действия на протяжении всего периода активной инфекции (пока не прекратятся высыпания и не начнут формироваться корочки). Note: etiotropic treatment involves the use of drugs of local and systemic action throughout the entire period of active infection (until the rash stops and crusts begin to form).

In parallel with antiviral drugs, patients are required to prescribe immunomodulatory agents that stimulate the production of interferon in almost all cells that are involved in the antiviral response of the body.

To relieve pain, patients are prescribed analgesics, ganglioblockers and nonsteroidal anti-inflammatory drugs. Also, some methods of physiotherapy treatment (Novocain blockade, ultrasound and diadynamics along the nerve fibers), as well as reflexology, plasmaphoresis and acupuncture, have proven themselves well.

Twice a day, the formed bubbles are recommended to be lubricated with special aniline dyes (methylene blue or brilliant green), and as they dry, use dressings soaked in dimexide or special antiviral ointments.

A warning! Treatment of shingles with corticosteroids is absolutely contraindicated!

Shingles Prevention

As a rule, there are no special anti-epidemic measures in the focus of infection. In this case, the prevention of the disease is to increase the resistance and any available forms of hardening of the body. Due to the fact that often herpes zoster affects older patients, the best prevention in the elderly is considered to be long walks in the fresh air and active motor mode.

Forecast

With the exception of the encephalitic form of shingles, the prognosis of the disease is favorable. Recurrences usually do not occur. And only in very weak people can the infection be activated again.


| 12th April 2014 | | 12 610 | Skin diseases
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  • | Evgenia | 24 August 2015

    I am 68 years old I got sick for the first time. I went to the doctor after 2 weeks with severe pain from the solar plexus and under the ribs to the scapula. There were rashes. Appointed VALVIR 1000mg and ALGERIKA 75mg. Sawed a week, absolutely nothing helps, the pain has become unbearable

Leave your feedback


Rhoj Luntayan: I had chickenpox when I was around 6-8 yrs old. I had shingles when I was around 14-15 y/o. It hurts so much even when you don't move 😣 Had a hard time sleeping.

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Michael McGoldrick: I got chickenpox when I was 17. One year later I got a minor case of shingles. (Small patch, lasted a week with meds). Now, I’m 20, and I just got shingles AGAIN in the same spot. Weird...

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