A disease manifested by the formation of rashes on the skin in the form of blisters filled with liquid, the appearance of which is preceded by severe pain and burning - this is either herpes zoster (Herpes zoster). The disease occurs as a result of the activation of the varicella zoster virus, which remains latent until the immunity of the virus carrier weakens due to the coincidence of a number of factors.
Almost always, the patient and his environment are interested in the question: In order to find out, you need to consider in detail the pathogenesis of the disease and the causes of herpes zoster.
How does the shingles virus manifest itself?
Virus Herpesviridae, which is the causative agent of two diseases at the same time - chickenpox and herpes zoster, in the latter case it affects the endings of nerve fibers. When the vegetative system is involved in the process nervous system, internal organs may be affected and meningoencephalitis may begin. If with chickenpox the virus exhibits its epitheliotropic properties, then with herpes zoster the neurotropic ones are in the foreground.
Within 1-5 days from the moment of activation of the virus, a strong pain.
During this period, errors in diagnoses are common; for example, inflammation of the nerve roots in the lumbosacral region can be mistaken for manifestations of radiculitis.
Signs of intoxication of the body appear: deterioration in general health, increase in temperature.
In places of occurrence pain symptom the skin may peel, itching and tingling appear, sensitivity increases sharply, even light touches of the skin or rubbing of clothing are painful.
A little later, a vesicular exanthema appears on the skin in the projection of the nerves affected by the virus. It is a large group of vesicles with watery (less often bloody) contents.
The peculiarity of herpes zoster is that it affects only one half of the torso, no matter which part of the body is affected.
After 3-4 weeks, the liquid in the blisters becomes cloudy, they become covered with a crust, which falls off, leaving behind a stain that does not disappear for a long time, similar to a burn mark. If the virus affects the nerves associated with internal organs, painful symptoms, similar to colic or inflammation.
In case of defeat facial nerve exanthema can occur on the cornea of the eye, eyelids, inflammation is possible lymph nodes affected side.
Herpes zoster causes severe pain until the rash goes away. Often the pain persists for much longer - several months or even years. Except pain a feeling of numbness may appear in the affected areas, which persists for a long time.
Shingles causes
The main cause of shingles is the activation of the virus present in a person who has had the disease. chicken pox. After suffering from chickenpox, the virus remains in the body, passing into a latent (hidden) form and begins to infect nerve endings when the body partially loses its immune defense.
Factors that reduce immunity may be:
- Old age (60 and older)
- Transferred oncological diseases and HIV infection
- Condition after radiation and chemotherapy
- Stress, chronic fatigue
- Organ or bone marrow transplant
- Long-term use of potent medications (immunosuppressants, corticosteroids)
- Diabetes
If the risk factors and causes of herpes zoster are known, you can take preventive measures - avoid stress, optimize your work and rest schedule, and undergo medical examination on time. Physical exercise and an increase in the proportion of food in the diet help improve immunity. fresh vegetables and fruits.
Possibility of contracting herpes zoster
Knowing how easily chickenpox is transmitted, patients are interested in: Is shingles contagious in humans? Those who have had chickenpox need not fear infection from a person with open manifestations of the disease. They have developed immunity to this virus and reinfection excluded. The only thing you need to worry about is the activation of your own virus.
And for those who do not have a history of chickenpox, shingles is contagious. But they will not get shingles, but chickenpox, since this type of herpes is a secondary infection. You can become infected by airborne droplets or through household items; a pregnant woman can transmit the virus to her child through the placenta.
How long is shingles contagious? Exactly as much as bubbles with liquid appear and burst on the skin. As soon as they crust over, you don’t have to worry about infection. The source of infection is the liquid that fills them, therefore, if a person with rashes touches them, and then touches objects accessible to other members of his environment, he exposes those around him to the risk of infection.
It should be taken into account that the virus that causes herpes zoster is very unstable; it is destroyed when exposed to solar insolation, disinfectants, and high temperature.
What tests will help make a diagnosis?
Routine blood and urine tests are not prescribed, since the diagnosis is made by appearance rashes. If the doctor has doubts (this happens more often when the disease affects internal organs), a very accurate and sensitive analysis of the bubbly liquid is done for PCR - polymerase chain reaction.
Herpes zoster and children
Many parents are concerned about the question - for children herpes zoster contagious disease or not? We can say with complete confidence that after contact with a sick person, a child has a high chance of becoming infected with chickenpox, if he has not yet had this infection. Cases of herpes zoster in children who have acquired immunity after chickenpox are very rare.
For children's herpes zoster, the cause and prerequisites for its occurrence are the same factors as in adults: decreased immunity after severe illness, taking hormonal drugs, the condition after radiation and chemotherapy. He appears general deterioration well-being, high temperature, the appearance of pain and discomfort at the site of nerve damage.
Treatment of herpes zoster
For a disease such as shingles, the causes and treatment are closely related to each other. Since the disease is viral in nature, the main drugs will be antiviral(Acyclovir). To alleviate the condition, use painkillers And anti-inflammatory(Baralgin, Pentalgin, Ibuprofen, Diclofenac), relieving itchy skin ointments and compresses with Menthol and Calamine.
Accelerate the formation of a crust of medication, the main active substance which is aluminum acetate(Burov's liquid), Fukortsin, brilliant green. If neuropathic pain becomes unbearable, move on to taking such analgesics, like Tramadol, Oxycodone, Methadone.
Herpes zoster– a sporadic infection that affects the nervous system in people with reduced immunity. Its manifestations are similar to the rashes of chickenpox, which is caused by the same virus, but are accompanied by severe, prolonged pain. To prevent the disease, it is necessary to prevent a decrease in immunity.
Herpes zoster belongs to the group of acute infectious diseases. Herpes zoster affects the peripheral nerves in some areas of the skin, which leads to intoxication of the body and inflammation of the dorsal roots spinal cord and the appearance of a blistering rash. As a rule, this infection affects adults and children over the age of 10 years, and shingles develops only in those people who have had chickenpox. Racial, gender and seasonal factors have no influence on the onset and progression of the disease.
Causes of herpes zoster
The causative agent of herpes zoster, the varicella zoster virus, affects the intervertebral nerve ganglia and dorsal roots of the spinal cord. The risk group includes people who:
- exposed to influences that weaken the immune system (chemotherapy, radiation treatment, immunotherapy, HIV infection);
- are often overworked or experience constant psychological stress;
- suffer from cancer;
- are elderly and pay little attention to their health.
All these factors can cause shingles, the symptoms of which appear as a result of the activation of the latent form of the varicella zoster virus. For many years, shingles may have had no clinical symptoms, but a coincidence of unfavorable factors forced him to wake up.
Signs of Shingles
There are four groups of symptoms of herpes zoster: pain, sensitivity disorders, general intoxication and skin manifestations.
Most often, sensitivity disorders with herpes zoster are observed in the area of rashes and healed ulcers, but can also appear on healthy areas skin. Signs of general intoxication include:
- weakness;
- decreased appetite;
- nausea, vomiting;
- temperature increase;
- loss of body weight.
Pain occurs several days before the appearance of the blistering rash. They intensify at night or under the influence of any external irritants (cold, heat, touch). When diagnosed with herpes zoster, pain is localized along the nerves and can vary from moderate to unbearable. In some cases, patients with herpes zoster note the presence of a severe headache, which intensifies when changing the position of the head.
Skin manifestations of herpes zoster are also localized along the nerves. They look like small red spots various shapes or small bubbles surrounded by a dark red rim. These bubbles are filled with transparent contents and disappear after a few weeks, leaving behind only a dried crust. If a person is diagnosed with advanced shingles, treatment of skin manifestations may last longer than usual, since the inflammatory process often affects the deeper layers of the skin and penetrates the dermis. In such cases, the blisters are also cured completely, but leave deep scars. As for the localization of the rash, in most patients it appears throughout the body, just like with chickenpox.
Possible complications of shingles
In case of severe clinical course and inadequate treatment, shingles can lead to serious complications. The most common ones are:
- paralysis resulting from damage to the motor branches of the nerves;
- pneumonia, duodenum, Bladder;
- eye lesions varying degrees heaviness;
- paralysis of the facial nerve and distortion of the face to one side.
Due to the risk of complications, doctors urge patients to abandon self-medication and promptly seek help from specialized institutions. If patients use exclusively folk remedies, shingles will never go away completely and will significantly reduce a person's quality of life.
Treatment of herpes zoster
The main measures are aimed at destroying the herpes virus and reducing the intensity of pain. Usually, medical workers apply antiviral drugs(metisazone, acyclovir, valacyclovir, famciclovir). To relieve pain, ganglion blockers (pyrylene, gangleron) are used. Note that severe pain can persist even after the rash disappears and the course of treatment is completed, therefore, upon discharge from the hospital, analgesics (aspirin, analgin, paracetamol, indomethacin) are recommended to patients. If severe, advanced shingles is diagnosed, treatment includes taking anticonvulsants and gamma-aminobutyric acid.
Traditional treatment for herpes zoster
Once again I would like to note that traditional treatment herpes zoster is an addition to the main medical procedures and nothing else. Otherwise, the patient risks many serious complications, including paralysis and distortion of facial features.
To relieve pain and itching in shingles, the following folk remedies are traditionally used:
- swimming in sulfurous or salty water;
- lubricating damaged skin areas with bitter almond oil;
- compresses of bread mixed with salt, which are applied to the body 1-2 times a day for 20-30 minutes;
- Folk remedies made from burdock leaves or fresh juice of this plant help well with shingles. Just keep in mind that before making a compress, the leaves must be poured with boiling water and left for 12 hours. Instead of burdock, you can use fresh toadflax herb, boiled with milk and mixed with butter in a 1:1 ratio.
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Shingles (herpes) is viral disease skin, which manifests itself as unilateral rashes and is accompanied by severe pain syndrome. The causative agent of the disease is the chickenpox virus - herpes zoster.
Herpes zoster affects the peripheral nerves in some areas of the skin, which leads to intoxication of the body, inflammation of the dorsal roots of the spinal cord and the appearance of a blistering rash. As a rule, this infection affects adults and children over the age of 10 years, and it develops only in those individuals who have had chickenpox.
At the same time, skin rashes are not the worst manifestation of the disease. Herpes zoster is dangerous because it damages peripheral nerves. Being in the nerve endings, the active virus destroys their structure, thereby causing unbearable pain in shingles and many neurological complications.
What it is?
The herpes zoster virus first enters the body during chickenpox. Elimination of chickenpox rashes does not mean the death of the infectious agent. The virus is contained immune system in a weakened state and after chickenpox is constantly in the body.
Shingles is external manifestation activated against the background of decreased immunity of the herpes virus. The disease is registered only in people who have had chickenpox!
Activations Herpes zoster is promoted by:
- hypothermia,
- previous acute respiratory infection or influenza (any other disease leading to a sharp weakening of the immune system),
- stress,
- visiting a solarium or prolonged exposure to the sun,
- oncology and radiation therapy,
- severe infections - HIV,
- long-term use of corticosteroids and treatment with immunosuppressants,
- pregnancy (often the disease proceeds without skin rashes and severe pain, but negatively affects the development of the fetus).
Classification
Clinical forms of herpes zoster can be as follows:
- gangliocutaneous form;
- eye and ear forms;
- necrotic form (gangrenous);
- a form of herpes zoster when it affects the autonomic ganglia;
- meningoencephalitic form;
- disseminated form;
- abortive form.
We will consider all these forms of herpes zoster and the symptoms characteristic of their course below, but first we will consider the main type of course of this disease.
Is shingles contagious to humans?
Shingles is contagious and it is important to understand what routes of transmission of a dangerous viral pathology exist.
The following methods of infection are possible:
- By airborne droplets, in which the virus is localized in the mucous membranes of the carrier of the infection, from where it enters the air after coughing or sneezing. Subsequently, the virus remains in the form of an aerosol until a healthy person inhales contaminated air.
- By contact, in which the virus enters the body of a healthy person after direct contact with the skin of an infected person.
How long is shingles contagious? Exactly as much as bubbles with liquid appear and burst on the skin. As soon as they crust over, you don’t have to worry about infection. The source of infection is the liquid that fills them, therefore, if a person with rashes touches them, and then touches objects accessible to other members of his environment, he exposes those around him to the risk of infection.
It should be taken into account that the virus that causes herpes zoster is very unstable; it is destroyed when exposed to solar insolation, disinfectants, and high temperature.
Most often, outbreaks are recorded in autumn and spring.
- At mild form pathological process skin nodules do not transform into vesicles.
- However, in severe forms of the disease, vesicular vesicles transform into ulcers, which after some time begin to ulcerate. In this case, shingles becomes protracted and lasts up to one and a half months.
Symptoms of herpes zoster
It is impossible not to notice the symptoms of shingles in an adult. Clinical picture characterized by an acute onset, with severe pain and severe burning at the site of the lesion.
The disease affects the area human body most often on one side.
Zones of localization of herpes zoster can be:
- Genitals;
- Buttocks:
- Lower and upper limbs;
- Intercostal areas;
- Face (part of it along the triangular nerve);
- Lower jaw;
- Back of the head;
If herpes zoster affects the facial part, then the rash will be located along the ternary or facial nerve. If an area of the body is affected, the rash will be located along the spinal nerves. This fact is explained by the high accumulation of the virus in the nerve ganglia, in 11 pairs cranial nerves, V hind horns in each half of the spinal cord. Therefore, cutaneous manifestations are localized along the involved nerve.
Experts distinguish three periods, each of which has its own symptoms of herpes zoster:
Onset of the disease
This period is called prodromal. It is accompanied by general malaise, psychovegetative (neurological) pain, which can have varying intensity. Duration initial period can range from 48 hours to 4 days.
In parallel, the patient experiences the following symptoms:
- Feeling weak;
- Headache;
- Increase in body temperature to subfebrile levels (fever is extremely rare, but does occur);
- Chills;
- Disorders of the functioning of the gastrointestinal tract and associated dyspeptic disorders;
- Pain, burning, itching, severe tingling in the area of the body or face where rashes will subsequently appear;
- As symptoms increase, the lymph nodes swell and become painful and hard to the touch;
- Disturbances in the process of emptying the bladder are observed in severe cases of the disease.
When body temperature drops, the symptoms caused by it in the form of intoxication are significantly weakened.
Period of rash
The time when rashes characteristic of shingles appear. The symptoms and nature of the rash depend on the severity inflammatory process. At first, the rash looks like lesions pink spots 2-5 mm in size, between which there are areas healthy skin.
- In the typical form of the disease, the next day, small, closely grouped vesicles and vesicles with transparent serous contents form in their place, which becomes cloudy after 3-4 days.
- In severe gangrenous form of herpes, the contents of the vesicles may be mixed with blood and black in color. Herpetic rashes have a wave-like course, as with chickenpox, that is, fresh rashes with vesicular elements appear at intervals of several days. The bubbles seem to crawl from one place to another, encircling the body, hence the name of this disease.
- In mild forms of the inflammatory process, the transformation of skin nodules into pustules does not form and their ulceration does not occur, and the manifestation of herpes is also possible only of a neurological nature - pain without a rash, otherwise it is also called herpetic neuralgia and is often mistaken for manifestations of intercostal neuralgia, osteochondrosis or heart pain. And therefore, inadequate treatment may be prescribed.
Crust formation period
After two weeks (maximum 1.5 weeks), crusts from yellow to yellow form in the place where the rashes were previously. Brown. The places where the vesicles were located lose their rich color.
Gradually, the crusts fall off, after which areas of pigmentation remain on the skin.
Shingles pain
A person always suffers from severe pain that occurs even from a slight touch to the skin. This is due to the fact that the virus is localized in nerve cells, disrupting their work and many times increasing the sensitivity of nerve endings. The pain that a person experiences can be compared to burn pain. They are especially aggravated when water gets into the affected areas. In this regard, scientists have not yet come to a common decision - whether it is worth taking a bath for shingles.
Some doctors are of the opinion that water procedures it is better to avoid, others believe that baths with the addition of sea salt, and still others recommend taking only a shower, after which the body will only need to get wet.
When describing the nature of the pain, patients indicate that it can be dull, burning or boring, some people compare it to the passage of an electric current through the affected area. Pain tends to increase after minor mechanical or thermal effects. They can continue to bother a person even after the rash has completely gone away. This happens to about 15% of all people who have had shingles.
The reason for residual pain is that viruses have destroyed nerve tissue, and it will take some time for them to recover. Most often, postherpetic neuralgia in old age can persist for several months, and in young people it disappears a maximum of 10 days after the rash disappears.
Shingles in the photo
Atypical forms
The typical course of herpes zoster is described above. Sometimes the disease gives an atypical clinical picture:
- Abortive form - there is no stage of formation of watery vesicles. Against the backdrop of absence skin rash the pain is just as intense.
- Bullous form - vesicles increasing in size merge, forming blisters of large diameter.
- Hemorrhagic form - deep tissue destruction with damage to the skin capillaries leads to the filling of the blisters with blood. Healing occurs with the formation of scars and dimples on the skin.
- Gangrenous form- deep ulcers form in place of the blisters. Healing is delayed, and eventually rough scars form in their place.
Consequences
- In severe cases of the disease, there may be facial paralysis or other paralysis due to damage to the motor nerves.
- There may also be violations from internal organs such as pneumonia, diseases genitourinary system, duodenum.
- If the eyes are affected, neuritis may occur optic nerve and visual acuity will decrease significantly.
- With a very dangerous encephalitic form of herpes zoster, a complication is meningoencephalitis - a serious disease that most often leads to disability.
- When a bacterial infection is added, purulent processes aggravate the patient’s condition, and the recovery process after the disease is delayed for months.
Forecast for not severe forms The disease is favorable, usually there are no relapses or serious consequences of herpes zoster. However, in weakened people after a severe inflammatory process, further exacerbations are possible.
Diagnostics
Laboratory research plays a very important role important role, as they make it possible to determine with 100% accuracy which virus is the source of the problem.
Tests for herpes zoster:
- Polymerase chain reaction.
- Immunofluorescence analysis.
- Serological method.
- Lymphoblastic transformation test (for babies in the womb).
One of the most common tests is the polymerase chain reaction, for which the contents of the vial and the patient’s blood are taken. The analysis allows you to identify the exact type of herpes virus through the isolation of its DNA and antibodies to the virus.
Shingles and pregnancy
The occurrence of shingles in pregnant women is quite alarm signal. Often it is pregnancy that becomes a predisposing factor that provokes the reactivation of the herpes zoster virus, which has been “dormant” for a long time in the body of the expectant mother.
Very often this disease becomes the cause of intrauterine infection. As a result, children are born with signs of severe damage to the nervous system or brain. Newborns may be diagnosed congenital blindness or deafness. The possibility of miscarriage, stillbirth, or death of the newborn cannot be ruled out.
How to treat shingles in adults
Most cases of shingles in adults resolve on their own, even without treatment. However, effective treatment exists and can significantly relieve the symptoms of the disease and also prevent complications.
The goals of treatment for Herpes zoster are:
- Speed up recovery;
- Reduce pain;
- Prevent complications;
- Reduce the likelihood of developing postherpetic neuralgia.
- Drug treatment is necessary for people with high risk complications or prolonged course of the disease: persons with immunodeficiencies, patients
- over 50 years old. The benefit of antiviral therapy in healthy and young people has not been proven.
Uncomplicated cases are treated at home (outpatient). Hospitalization is indicated for all people with suspected disseminated process, with damage to the eyes and brain.
Painkillers
Pain relief is one of the key points in the treatment of herpes zoster. Adequate pain relief makes it possible to breathe normally, move and reduce psychological discomfort. In the USA, they are used for pain relief. narcotic analgesics, such as oxycodone.
Non-narcotic analgesics are used:
- Dexketoprofen
- Ibuprofen
- Naproxen
- Ketorolac
- Ketoprofen
For post-herpetic neuralgia, capsaicin-based products are effective. Drug of choice for relief severe pain and the prevention of post-zoster neuralgia is amantadine sulfate due to its own virostatic properties and the ability to block peripheral NMDA receptors at the stage of pain impulse transmission.
Antiviral agents
Acyclovir, valacyclovir and famciclovir are used to treat shingles. Valacyclovir is a metabolic precursor of acyclovir and is completely converted into it by liver enzymes. The acyclovir molecule has the ability to integrate into viral DNA, thus stopping its replication and multiplication of viral particles. Famciclovir is transformed in the body into penciclovir and acts similarly.
The effectiveness and safety of these drugs has been proven by numerous studies. When starting therapy within 72 hours from the appearance of the first rash, they can reduce the severity of pain, reduce the duration of the disease and the likelihood of postherpetic neuralgia. Famciclovir and valacyclovir have a more convenient regimen than acyclovir, but they are less studied and several times more expensive.
Anticonvulsants
Anticonvulsants ( anticonvulsants) are commonly used for epilepsy, but they also have the ability to reduce neuropathic pain. For Herpes zoster, some of them can be used, such as gabapentin and pregabalin.
Corticosteroids
Corticosteroid medications reduce inflammation and itching. Some studies have shown their ability in combination with antiviral agents reduce symptoms of mild and moderate forms of the disease.
Despite these data, corticosteroids have not gained acceptance for the treatment of herpes zoster due to safety reasons. Currently, these drugs are not recommended for use in this disease.
Vitamin therapy and diet
Also, for shingles, it is recommended to take the following vitamins to strengthen the immune system:
- Vitamin A;
- Vitamin E;
- Vitamin C.
These vitamins, being antioxidants, reduce the ability of cells to respond to inflammation and also help increase the body's defenses.
- B vitamins.
Vitamins from this group improve epithelial regeneration, participate in the formation of antibodies, as well as in all metabolic processes.
It should also be taken into account that during treatment, a patient with herpes zoster is recommended to have a gentle diet rich in nutrients, vitamins and microelements. It is recommended to boil or steam food, and you should also reduce the consumption of salty, fatty and fried foods.
- dairy ( milk, kefir, butter, cottage cheese);
- vegetables ( beets, broccoli, carrots, eggplants, zucchini, pumpkin, tomatoes, peppers, onions);
- white meat;
- seafood ( salmon, pike perch, herring);
- nuts ( peanuts, pistachios, almonds, walnuts, cashews);
- fruits ( grapes, apricots, apples, kiwi, plums, citrus fruits);
- cereals ( oat, wheat, barley cereals);
- legumes ( peas, beans);
- green tea, tea with rosehip or raspberry.
Is it possible to swim if you have shingles?
Shingles is a strict contraindication to taking a bath or shower. Areas with rashes and nearby skin should never be wet to prevent the spread of infection.
Partial washing of hands/feet, wiping the neck and face with a damp cloth is acceptable, provided there are no rashes on them. In this case, the patient must be given a personal towel and change his underwear regularly.
How long does the pain from shingles last?
Even after effective treatment In 70% of patients, intense pain persists for some time (several months and even years, on average 3-6 months).
Postherpetic neuralgia is caused by the destruction of nervous tissue, and it is the nervous tissue that is characterized by a long recovery. Therefore, it is so necessary to begin comprehensive treatment from the first days of the disease.
Is it possible to get sick again?
When the varicella zoster virus enters the human body, it causes chickenpox ( chicken pox).
However, after recovery, this virus is not eliminated, but remains in the human body in a latent state. This virus lurks asymptomatically in nerve cells in the dorsal roots of the spinal cord. The virus is activated when exposed to the body negative factors that contribute to a decrease in immunity. IN in this case the disease recurs, only not in the form of chickenpox, but in the form of herpes zoster. As a rule, re-occurrence of shingles is not observed in the future. In patients with normal health, relapse of herpes zoster is observed in two percent of cases.
In ten percent of people, a relapse of herpes zoster is observed in the presence of the following pathologies:
- HIV infection;
- AIDS;
- oncological diseases;
- diabetes;
- lymphocytic leukemia
In this regard, to reduce the risk of relapse of the disease, as well as to prevent the development of herpes zoster, a vaccine against the Varicella-zoster virus was released in 2006. This vaccine showed good results, reducing the risk of developing the disease by 51%.
The purpose of introducing a vaccine is to create an artificial active immunity in relation to the Varicella-zoster virus.
Prevention
There is no specific prevention herpes virus disease. It can only consist of maintaining the natural human immune system and increasing the body's resistance.
This is facilitated by maintaining healthy image life, abandonment bad habits, active physical regime, adherence to rules healthy eating, adequate sleep, hardening, walks fresh air, avoiding the aggressive influence of ultraviolet rays, harmonious psycho-emotional state person.
Forecast
With the exception of the encephalitic form of herpes zoster, the prognosis of the disease is favorable. Relapses, as a rule, do not occur. Only in very weakened people can the infection become active again.
Shingles is a disease that is the reactivation of a dormant viral infection.
The causative agent is the varicella zoster virus (herpes virus type 3). Outside of an exacerbation of herpes zoster, the virus is localized in the spinal nerve roots. Herpes zoster occurs with damage to the dorsal roots of the spinal cord and intervertebral nerve ganglia, fever, intoxication and blistering rash along the sensory nerves.
Causes
The main routes of transmission of the virus are similar to those of chickenpox - airborne droplets and contact (through the discharge of blisters). Shingles is seasonal - the incidence increases in the colder months. When contacting someone with shingles, children can become infected with chickenpox.
The development of the disease is considered as a result of reactivation of the virus in persons who have had chickenpox; the triggers for reactivation remain unstudied, but patients with immunodeficiencies, tumors, who have received various injuries and drug addicts.
Symptoms of herpes zoster
Characterized by an acute onset, fever, pronounced burning pain at the site of future rashes. Rashes appear along individual sensory nerves in the form of fuzzy pinkish spots (3-5 cm), against which after 18-24 hours groups of painful blisters form.
Most often the lesions are located on chest, but can also be located along any sensory nerve and, as a rule, on one side. The rash disappears within 2-4 weeks, but pain may persist for weeks or months.
Ocular form of herpes zoster
It is characterized by a particularly severe course. Accompanied by damage to the trigeminal ganglion. The rashes are localized along the branches of the trigeminal nerve - on the mucous membranes of the eye, nose, and facial skin; often the eyeball is involved in the process.
Gangrenous (necrotic) form
It manifests itself as deep skin lesions with scar formation.
Any of the forms may be accompanied by damage to the autonomic nodes of the nervous system with the development of symptoms unusual for herpes zoster (urinary retention, constipation or diarrhea).
The disease may be one of the first signs of HIV infection. Often, such patients develop herpes zoster with widespread skin lesions, clinically reminiscent of chickenpox.
The diagnosis is made based on the manifestations of the disease. Research methods are rarely necessary
Treatment of herpes zoster
Antiviral drugs, when used within 48 hours after the onset of the rash, accelerate its resolution and eliminate the symptoms of the disease, reduce pain in the acute phase, and are absolutely indicated for concomitant serious illnesses and eye damage.
- acyclovir 800 mg 5 times a day every 4 hours (except at night) 7-10 days
- or famciclovir 500-750 mg 3 times a day orally for 7 days
- paracetamol, diclofenac - for pain
- silver sulfadiazine - topically for suppuration of the rash
- idoxuridine - eye drops, with eye damage.
Resolution of the rash usually occurs within 14-21 days. The pain may persist for several weeks. Complications of herpes zoster are rare.
Shingles is dangerous disease, the cause of which is the herpes virus. It affects both the human skin and the nervous system, and experts consider this condition to be extremely serious. The same infectious agent provokes the development of a serious illness in adults, however, the second one often occurs again.
After reading the information below, you will learn how to treat shingles and what ointments you will need for this, but in any case, at the first symptoms of the disease, you should consult a dermatologist.
Causes of the disease
It is important to know that the herpes zoster virus (Herpeszoster) first enters the body during illness, and the disappearance of characteristic rashes does not mean the elimination of the infectious agent. The pathogen is contained by the human immune system in depressed state, is activated in autumn and spring - during dangerous periods for patients with chronic diseases.
Symptoms of shingles occur due to hypothermia and stress. Activation of the virus is also facilitated by factors such as previous colds and prolonged exposure to the sun. Doctors often classify visiting a solarium as an undesirable activity that increases the risk of rashes.
Severe infections oncological diseases And long-term treatment hormonal drugs are also considered to be the causes of the development of herpes zoster.
Symptoms of a viral disease
Signs of shingles in people appear acutely, as a strong burning sensation is felt at the site of the pathogen. Most often, the rash is found on the face - where the trigeminal nerves, that is, on the back of the head, forehead, neck, as well as in the genital area, on the chest or back.
The body is sometimes covered with characteristic rashes in the area of the dermatome - areas of the skin that receive innervation from one cranial or spinal nerve, the lesions are localized along the plexus of fibers.
Doctors call shingles a complex disease and distinguish the following periods:
- prodromal or initial;
- manifestation of rashes;
- stage of healing of skin lesions.
Usually initial stage Shingles is characterized by malaise, and patients also note neuralgic and headaches, while body temperature rarely rises. Work is disrupted gastrointestinal tract, a sick person experiences itching and tingling in the area peripheral nerves, later rashes will appear there.
Lymph nodes often enlarge and cause discomfort; in severe cases, symptoms such as urinary retention and joint pain are possible.
The causes of shingles lie in decreased immunity, in which case the disease is quite severe. During the period when rashes appear, a person becomes covered, between which areas of healthy skin are visible. Using photographs, you can easily identify the symptoms of a dangerous disease.
Herpes zoster in humans in its typical form is characterized by the formation on the next day of small and localized vesicles - vesicles with serous fluid, which becomes cloudy after a few days.
Less common is the gangrenous form of shingles, when the contents of the blisters are black, as there is an admixture of blood there. Herpetic skin lesions are characterized by a wave-like course, similar to ordinary chickenpox; vesicles affect new areas of the body, justifying the name of the disease.
Mild forms of herpes zoster are common, with patients complaining of pain without the appearance of a rash, which is why doctors mistake them for osteochondrosis and other ailments.
The final period of the disease is characterized by the formation of crusts at the site of the rash; this happens on average 2 weeks after its onset. Over time, the vesicles turn pale and dry out, leaving behind subtle pigmentation. Less often, the blisters open, erosion appears, which is fraught with the development of pustules.
If a person’s immunity is reduced, then his body is susceptible to secondary infection caused by the activity of streptococci and staphylococci.
Painful sensations from herpes zoster
The signs of this disease are easy to recognize from the photo, as well as an integral symptom viral infection becomes increased sensitivity nerve endings and, as a result, sharp pain in the area where the infectious agent is localized. If the patient is prescribed treatment at home, the doctor considers the need for water procedures.
Shingles is a contraindication to taking a bath, it is not advisable to wet areas with rashes to avoid the spread of the virus throughout the body. Only partial washing of hands and feet and wiping the face and neck with a damp towel is permissible.
The pain of shingles resembles a burning sensation, less often it is similar to tingling and intensifies at the slightest touch or contact with moisture. Doctors note that discomfort persist in some people who have had this infection.
Contrary to popular belief, the disease does not progress, but the functioning of nerve tissues is disrupted. This phenomenon is called postherpetic neuralgia; it lasts from 1 month to 1 year, depending on the age and characteristics of the patient’s body.
The degree of contagiousness of herpes zoster
People who are sick often ask, is shingles contagious? It is important to know that a person who has previously had chickenpox has a low chance of becoming infected with this disease when interacting with a patient. However, with a decrease in immunity and in unfavorable environmental conditions, episodes of disease development become more frequent.
Not all people who have had herpes develop stable protection against the pathogen, so they risk becoming infected when communicating with a sick person.
Diagnosis of viral infection
Medical practice shows that an external examination allows a correct diagnosis to be made in most cases, but in the prodromal period the disease can be mistaken for another ailment. Often, shingles goes unnoticed, and diseases such as pleurisy, angina pectoris, and even pulmonary infarction are falsely diagnosed.
Less often it is mistaken for eczema or erysipelas, so it is advisable to use using the following methods diagnostics:
- microscopy;
- determination of immunoglobulin titer;
- growing the virus on a nutrient medium.
These methods allow doctors to accurately identify herpes zoster in adults based on symptoms and prescribe treatment.
Treatment of a viral disease
In young and healthy people with strong immunity, not suffering from chronic diseases and other phenomena, the treatment of this ailment does not take much time. First of all, you need to contact a therapist, who will write out a referral for a visit to a dermatologist or infectious disease specialist, or you can go directly to the specified specialists.
A severe course of the disease requires contacting a neurologist or ophthalmologist if the rash affects the skin of the face. Doctors, according to the international classification, refer to dangerous infections herpes zoster, ICD 10 code for this disease is B02.
The first task for the attending physician and the patient is to combat pain and burning, so it makes sense to take painkillers. Medicines such as Paracetamol, Ibuprofen or anesthetic gel help eliminate itching and burning, thereby returning the person to their normal lifestyle.
The specialist can also prescribe to the patient special drugs for the treatment of this type of lichen:
- Acyclovir and other antiviral tablets;
- Antibiotics;
- Anticonvulsants.
Treatment of shingles in older people is aimed at powerful suppression of the virus, so you need to take the prescribed medications for 2 weeks. Patients receive the drug Acyclovir continuously throughout the period of illness, drinking 1 tablet several times a day.
Based on the severity of the disease, the doctor may prescribe a double dose of the medicine, however, you cannot increase the number of tablets on your own. Intravenous administration The drug makes sense for complicated forms of herpes zoster.
Based on the drug Acyclovir, doctors developed Famvir - effective medicine against resistant strains of the virus, which is sold strictly according to a doctor’s prescription. These tablets are taken 3 times a day for 1 week of illness, and the dosage is always indicated by a specialist after examination and examination of the patient.
Patients with reduced immunity receive a double dose of Famvir to achieve optimal results. The drug Valacyclovir is used according to a similar scheme, but it is important to take into account side effects from taking pills.
It is important to consider the causes of the disease and select suitable treatment. The gangrenous form of herpes zoster requires treatment antibacterial agents- Erythromycin, Gentamicin, Oxacillin and other drugs aimed at combating staphylococcus.
People with epilepsy should additionally take pills that reduce the risk of convulsions. Gabapentin and Pregabalin are prescribed by a specialist who has reviewed the patient’s medical history.
All sick people, without exception, benefit from walks in the fresh air during the period of treatment for herpes zoster, as well as vitamins to boost immunity.
Treating the skin during illness
Experts know how to treat shingles, so remember that it is unacceptable to self-medicate or be exposed to ultraviolet light, as in this case the virus will increase its activity and it will be more difficult to cope with it. The same rule applies to body care during the formation and healing of rashes.
Inexpensive and popular formulations are a solution of brilliant green, boric acid and potassium permanganate have a drying effect, but they should be used under the supervision of a doctor. They turn out to be much more effective antiviral ointments and gels:
- Zovirax;
- Acyclovir;
- Infagel.
Treatment for shingles includes treatment skin and requires proper therapy. Doctors recommend treating rashes with antiseptics, being careful, and 30 minutes after disinfecting the dermis, starting to apply antiviral agents.
Thus, the skin will recover quickly without the formation of prominent scars and pigmentation. It is important to know that it is prohibited to use corticosteroid drugs in any form; they suppress the immune system and the body is unable to contain the virus.
Possible complications
A severe course of the disease is fraught with damage to the facial nerve, which leads to its paralysis, and doctors also note disturbances in the functioning of internal organs - diseases of the genitourinary system, and other phenomena. If the rash reaches the skin of the face, the risk of vision impairment increases, bacterial infections delay the recovery process for many months.
In people with high immunity, the prognosis for shingles is generally favorable; they do not experience serious consequences.
