Herpes shingles: photos, symptoms and treatment in adults
Herpes zoster, or shingles, a pathology that is provoked by the Varicella zoster virus, is characterized by herpetiform eruptions on the skin, damage to the central and peripheral nervous system, and develops against the weakening of the body's immune defenses.
Pathology is common enough, so it attracts attention not only dermatologists and neuropathologists, but also doctors of other specialties.
Shingles caused by the same virus as chicken pox. Infection occurs by contact or airborne droplets. This virus can persist in the human body in a latent state for years and decades.
If there was a history of chickenpox, which is usually sick in children, you can get herpes zoster even in old age, which very often happens in principle. And the reason for this is a decrease in immune defense as a result of the influence of various factors. A dormant infection in the body, which has not been clinically manifested for many years, is activated by involving the ganglia and nerve roots in the process.
The most common causes of herpes zoster are:
In adults, the clinical picture of symptoms is composed of dermatological manifestations and neurological disorders. Typical for the disease is a specific sign - one-sided defeat. That is, the rashes are localized on one half of the body along the nerve trunks and never appear on the other side.
At first, the disease manifests itself with sudden burning and unbearable pains in the area of future rash. In this period, which can last from 1-2 to 10-12 days, there are no external symptoms. The pain syndrome rises under the influence of various kinds of irritants( the touch of the laundry, the effect of temperature), becomes more intense at night and is often accompanied by vegetative vascular dystonia.
Further along the branches of the affected sensory nerve there is reddening and infiltration of the skin, single bubbles appear up to 3 mm in diameter, filled with a clear liquid. Over time, they begin to occupy an ever larger surface of the skin, closely adjoining each other, but not merging. The contents of the vesicles grow turbid and after 8-10 days they dry up, crusts form which disappear approximately a month later. In their place is a short-term red-brown pigmentation.
Most often, the appearance appears on the body and limbs, but perhaps its location on the skin of the face and head. In this case, the branches of the trigeminal and facial nerves are affected. This form of the disease can lead to neuralgia and paralysis of these nerves with a duration of up to several weeks.
Along with the pouring out, there may be other symptoms of herpes zoster. These include: a fever of 39 ° C, an increase in lymph nodes, a sensitivity disorder in the area of ganglion damage, a headache, and general malaise. The severity of the disease is associated with the location of the rash. Especially dangerous are cases of localization of exanthema on the face and scalp, as the development of serous meningitis is not ruled out.
After suffering herpes zoster usually begins a persistent remission, and the disease passes without consequences. But in some cases, painful sensations( postherpetic neuralgia) may persist for several months or even years.
Look also, the symptoms of genital herpes.
Lung variants of the disease are usually treated on an outpatient basis. Hospitalization in the infectious department is indicated with the threat of affecting the eyes and brain. Treatment of herpes zoster in adults is aimed at reducing pain, preventing secondary infection of vesicles and preventing complications. This is achieved through the use of antiviral, analgesics, antidepressants, ganglioblokatorov.
Antiviral drugs reduce the severity of the pain component, the duration of the disease, and also prevent the development of postherpetic neuralgia, provided they are used within the first 72 hours after the appearance of the rash. This includes acyclovir and famciclovir. The course of treatment is from 7 to 10 days.
Painkillers give a chance to move and breathe normally, which often becomes impossible with lesions of the intervertebral ganglia. Usually for the removal of severe pain use non-narcotic analgesics: ibuprofen, ketorolac, ketoprofen. The pain component is also successfully removed by ganglion blockers and anticonvulsants( carbamazepine).The effect is observed already on 3-5 day from the beginning of application.
An additional method of treatment is the procedure of percutaneous electrostimulation, which is performed to normalize the work of the nerves. Also shown are injections of pain medications in tissues surrounding the nerves.
In the initial period of the disease, until the rash has passed, it is not recommended to take a bath or wash under the shower. But if there is an acute need, it is better to take a shower, after which the affected areas of the skin need to gently blot with a towel.
Although after treatment there is a long-term remission, it is impossible for adults to completely get rid of herpes zoster and on the signal of the immune or nervous system the virus can go into an active form, which will have to be dealt with again.
See also how to properly treat herpes on the lips.
In order to avoid the disease, it is necessary to minimize the effect of provoking factors and to strengthen immunity. There is also a special vaccine that is shown to adults over 60 years of age, regardless of whether they have herpes zoster or not.
In practice, vaccination against this disease is very rare, due to the lack of understanding by patients and doctors of the need for the vaccine, as well as inadequately organized infrastructure.
If treatment was started on time, the disease has a favorable course and lasts approximately 2-4 weeks. If untimely referral to the doctor, herpes zoster is delayed and neuralgia may occur.
This is the most common complication, which can cause pain for a long time at the site of the last rash. Preservation of pain occurs due to disruption of the nerves that have been damaged by the virus.
In addition to the complications include:
Pathology is common enough, so it attracts attention not only dermatologists and neuropathologists, but also doctors of other specialties.
Causes of herpes zoster
Shingles caused by the same virus as chicken pox. Infection occurs by contact or airborne droplets. This virus can persist in the human body in a latent state for years and decades.
If there was a history of chickenpox, which is usually sick in children, you can get herpes zoster even in old age, which very often happens in principle. And the reason for this is a decrease in immune defense as a result of the influence of various factors. A dormant infection in the body, which has not been clinically manifested for many years, is activated by involving the ganglia and nerve roots in the process.
The most common causes of herpes zoster are:
- long-term use of corticosteroids or immunosuppressants;
- being in a state of constant stress;
- subcooling;
- infectious diseases that drain the immune system( sore throat, flu);
- malignant neoplasms;
- ultraviolet irradiation( sun, solarium);
- chemotherapy;
- acquired immunodeficiency syndrome.
Symptoms of herpes zoster
In adults, the clinical picture of symptoms is composed of dermatological manifestations and neurological disorders. Typical for the disease is a specific sign - one-sided defeat. That is, the rashes are localized on one half of the body along the nerve trunks and never appear on the other side.
At first, the disease manifests itself with sudden burning and unbearable pains in the area of future rash. In this period, which can last from 1-2 to 10-12 days, there are no external symptoms. The pain syndrome rises under the influence of various kinds of irritants( the touch of the laundry, the effect of temperature), becomes more intense at night and is often accompanied by vegetative vascular dystonia.
Further along the branches of the affected sensory nerve there is reddening and infiltration of the skin, single bubbles appear up to 3 mm in diameter, filled with a clear liquid. Over time, they begin to occupy an ever larger surface of the skin, closely adjoining each other, but not merging. The contents of the vesicles grow turbid and after 8-10 days they dry up, crusts form which disappear approximately a month later. In their place is a short-term red-brown pigmentation.
Most often, the appearance appears on the body and limbs, but perhaps its location on the skin of the face and head. In this case, the branches of the trigeminal and facial nerves are affected. This form of the disease can lead to neuralgia and paralysis of these nerves with a duration of up to several weeks.
Along with the pouring out, there may be other symptoms of herpes zoster. These include: a fever of 39 ° C, an increase in lymph nodes, a sensitivity disorder in the area of ganglion damage, a headache, and general malaise. The severity of the disease is associated with the location of the rash. Especially dangerous are cases of localization of exanthema on the face and scalp, as the development of serous meningitis is not ruled out.
After suffering herpes zoster usually begins a persistent remission, and the disease passes without consequences. But in some cases, painful sensations( postherpetic neuralgia) may persist for several months or even years.
Look also, the symptoms of genital herpes.
Treatment of herpes zoster
Lung variants of the disease are usually treated on an outpatient basis. Hospitalization in the infectious department is indicated with the threat of affecting the eyes and brain. Treatment of herpes zoster in adults is aimed at reducing pain, preventing secondary infection of vesicles and preventing complications. This is achieved through the use of antiviral, analgesics, antidepressants, ganglioblokatorov.
Antiviral drugs reduce the severity of the pain component, the duration of the disease, and also prevent the development of postherpetic neuralgia, provided they are used within the first 72 hours after the appearance of the rash. This includes acyclovir and famciclovir. The course of treatment is from 7 to 10 days.
Painkillers give a chance to move and breathe normally, which often becomes impossible with lesions of the intervertebral ganglia. Usually for the removal of severe pain use non-narcotic analgesics: ibuprofen, ketorolac, ketoprofen. The pain component is also successfully removed by ganglion blockers and anticonvulsants( carbamazepine).The effect is observed already on 3-5 day from the beginning of application.
An additional method of treatment is the procedure of percutaneous electrostimulation, which is performed to normalize the work of the nerves. Also shown are injections of pain medications in tissues surrounding the nerves.
In the initial period of the disease, until the rash has passed, it is not recommended to take a bath or wash under the shower. But if there is an acute need, it is better to take a shower, after which the affected areas of the skin need to gently blot with a towel.
Although after treatment there is a long-term remission, it is impossible for adults to completely get rid of herpes zoster and on the signal of the immune or nervous system the virus can go into an active form, which will have to be dealt with again.
See also how to properly treat herpes on the lips.
Prevention
In order to avoid the disease, it is necessary to minimize the effect of provoking factors and to strengthen immunity. There is also a special vaccine that is shown to adults over 60 years of age, regardless of whether they have herpes zoster or not.
In practice, vaccination against this disease is very rare, due to the lack of understanding by patients and doctors of the need for the vaccine, as well as inadequately organized infrastructure.
Complications of
If treatment was started on time, the disease has a favorable course and lasts approximately 2-4 weeks. If untimely referral to the doctor, herpes zoster is delayed and neuralgia may occur.
This is the most common complication, which can cause pain for a long time at the site of the last rash. Preservation of pain occurs due to disruption of the nerves that have been damaged by the virus.
In addition to the complications include:
- impaired sensitivity;
- decreased vision;
- suppuration as a result of attachment of a bacterial infection;
- inflammation of the auditory and facial nerves;
- movement disorders up to the paralysis of the hands and feet;
- spread of the herpes virus to internal organs;
- meningitis, encephalitis( rarely).