Shingles (lumbar) is a dangerous disease of a viral nature, the presence of which is evidenced by characteristic painful symptoms. Its causative agent is chickenpox virus. The disease affects not only the skin, but also the nervous system.
What is the pathogenesis of this disease? What are the symptoms of infection? How is the diagnosis carried out and what is needed for treatment? Well, this and much more will be discussed now.
Briefly about the virus
Before you talk about the symptoms and treatment of lumbar lichen, a photo of which clearly shows its unpleasant manifestations, you should study the pathogenesis.
The causative agent of the disease belongs to the family of herpes viruses. When the Varicella zoster virus attacks the body for the first time, the result is usually typical chickenpox. In the vast majority of cases, people get sick at an early age.
After the disease passes, the virus becomes latent. It hides in the ganglia of the autonomic nervous system, cranial nerves or in the cells of the posterior horns of the spinal cord.
The virus may not manifest itself for decades. However, when the preconditions for the appearance of lumbar lichen appear (they will be discussed later), he leaves the nerve cells and moves along the axons. When the virus reaches the end of the nerve, an infection develops. Where are its manifestations observed? In the place that is innervated by this nerve.
This can happen at any age, but people over 50 are at risk. At this time, patients most often suffer from chronic diseases, immunity is also weakened, and therefore it becomes easier for the virus to penetrate the blood. Also at risk are people living in poor environmental conditions.
The most dangerous time is spring and autumn. In these seasons, chronic diseases worsen, infections and viruses that are in a latent state are reactivated.
Cause
Tinea (lumbar) lichen (photo of the rash is presented in the article below) occurs due to a malfunction of the immune system. The prerequisites that increase the likelihood of reactivation of the virus include:
- Diseases of the blood-forming organs and blood.
- Malignant oncological diseases.
- Autoimmune pathologies.
- Diabetes.
- HIV
- Radiation and chemical therapy.
- Bone marrow or organ transplant.
- Severe injuries.
- Heart or kidney failure.
- Tuberculosis.
- Cirrhosis, hepatitis.
- Taking glucocorticosteroids, as well as immunosuppressive drugs.
- Chickenpox in adulthood.
- Strengthened virus zoster.
- Infectious and neurological diseases.
- Physical and psychological overwork.
Since this virus is localized in nerve tissues, chronic stress and nerve stress are most often the cause.
Primary manifestations
Having dealt with the causes of lumbar lichen, you should proceed to the study of its symptoms. The disease begins to manifest itself acutely. Symptoms appear at the location of the virus - there is a burning sensation, severe discomfort.
As a rule, these are zones that are innervated by one nerve. Namely:
- Intercostal region.
- Back.
- Chest.
- Shoulders.
- Buttocks.
- Genital area.
- Lower and upper jaw.
- Forehead.
The initial period, also called prodromal, is characterized by neuralgic pains and general malaise. It lasts 2-4 days. Here is what is characteristic of this period:
- Strong headache.
- Weakness and chills.
- Fever. Sometimes it increases to +39 ° C, fever occurs.
- Violations of the digestive tract.
- Dyspeptic disorders.
- Burning, itching, pain and tingling.
- Urinary retention.
- Enlarged and sore lymph nodes.
When the temperature drops, all intoxication disorders also weaken.
Rash period
It usually occurs in 3-5 days. The nature of the rash and its other features depend on how severe the inflammatory process itself is. This generally affects the severity of symptoms of lumbar lichen.
At first, the rashes look like small pink spots, the diameter of which does not exceed 2-5 mm. They are located at a certain distance from each other, between them there are areas of healthy skin.
Then small, very closely grouped vesicles form. These are vesicles with specific serous contents. After a few days, it becomes cloudy.
If a person has a gangrenous form of lumbar lichen (the causes are the same, but the symptoms are more intense), then blood is usually also present in the vesicles. The vesicles themselves can be black.
Rashes have a wave-like course. A few days after the initial appearance, new, fresh ones are formed. Bubbles seem to move from one place to another, thus encircling the body. As a matter of fact, because lichen is called shingles.
If a person is lucky and has a mild form, then skin nodules do not turn into pustules. No ulceration is observed.
Sometimes there isn’t even a rash. Then this is called a herpes of a neurological nature - a person just feels pain. However, such cases are no less dangerous, since sometimes this symptom is mistakenly perceived as a manifestation of osteochondrosis or intercostal neuralgia. Therefore, they may prescribe inadequate treatment, which will only aggravate the situation.
Recovery
As a rule, 2-3 weeks after the appearance of visual symptoms of lumbar lichen (the photo above clearly demonstrates them), crusts appear on the place where the rashes formed.
All those places where there were vesicles begin to turn pale, and then dry. The crusts that have turned yellow-brown fall off, leaving a slight depigmentation.
This is called self-healing. However, there are often cases when patients with itching persist for several months or even years. This phenomenon was called postherpetic neuralgia.
Diagnostics
If disturbing symptoms appear, consult a physician for advice. Or immediately to a dermatologist, immunologist or neuropathologist.
In the vast majority of cases, the diagnosis is made after an external examination. It is enough to study the appearance of the vesicles, as well as analyze the patient's complaints.
In the event that the diagnosis is in doubt, the doctor prescribes an analysis of the rash for the virus. This test aims to identify giant multinucleated cells in the biomaterial. But it is not carried out everywhere.
By the way, is lumbar lichen transmitted or not? Since the causative agent is a virus, then yes. But a person who once had chickenpox may not be afraid - he will not be able to infect him for sure.
Drug therapy
The causes, symptoms, and photos of lumbar lichen were discussed above. About treatment and its basic principles should also be told.
Immediately after the doctor diagnoses the infection, antiviral therapy begins. Serious consequences and serious complications can be avoided if treatment begins in the first three days after the formation of the rash.
What kind of drugs will need to be taken - the doctor will tell after the examination. But as a rule, the following funds are prescribed:
- Antiviral: Famciclovir, Vacyclovir, and Acyclovir.
- Painkillers: Naproxen, Aspirin, Paracetamol and Ibuprofen.
- Corticosteroids. They are taken only in severe cases, be sure to simultaneously with antiviral.
- Local antibiotics in the form of creams for the treatment of rashes: "Acyclovir", "Alpizarin", "Zovirax", as well as heparin ointment, funds based on penciclovir and lidocaine.
Therapy can be comprehensive. Usually prescribed "Acyclovir" (5 times a day for 0.8 g) and "Famciclovir" (3 times a day for 0.25 g). The duration of treatment is 7 days. Analgesics and non-steroidal drugs can not be taken for longer than 5-7 days.
How to relieve pain?
This issue deserves special attention. Many people who have encountered this ailment know firsthand how much discomfort the lumbar lichen causes. How to quickly anesthetize the affected area?
Such drugs as Melipramin, Ixel, Imizin, Doxepin, Clomipramin and Amitriptyline can cope with even the most severe pains.
They quickly and effectively relieve suffering. Because the components that make up these drugs help to increase the level of neurotransmitters, which are responsible for the normal state of the nervous system. It’s possible not only to get rid of pain - appetite, disturbed sleep also normalize, interest in life returns.
In addition, novocaine blockades are situationally prescribed. This approach is also aimed at relieving acute pain attacks.
You can also use a pepper hood. It neutralizes pain by acting on the nerve roots. An alternative are anesthetic ointments and patches with lidocaine.
In especially severe cases, narcotic anesthetics are used - Tramadol and Oxycodone. Their doctor prescribes if all of the listed drugs have been powerless.
Recommendations
It is worth remembering some useful tips that will help you easier to transfer lumbar lichen to a child or adult. The recommendations are as follows:
- Do not scratch affected skin, even if the itching is unbearable.
- To get rid of discomfort, you need to use wet cold compresses.
- Sores can be dried quickly using baking soda or corn starch.
- Vesicles can be treated with aluminum subacetate (Burov's fluid). This will help not only remove the crusts, but also effectively dry the affected skin.
- If suppuration occurs, then you need to see a doctor so that he prescribes a cream or ointment with an antibiotic in the composition.
- It is important to observe hygiene measures. The skin must be carefully taken care of, not forgetting about individual medical recommendations.
By the way, many people are interested in whether it is possible to wash in the presence of shingles (lumbar) versicolor? Yes, but not often. The best option is a shower, after which you should not wipe with a towel. It’s enough to get your skin slightly wet.
Postherpetic Neuralgia (PHN)
Talking about how to treat lumbar lichen (it has arisen from a cold or as a result of any other ailment that weakened the immune system), it is necessary to make a reservation that PNH appears in 10-15% of patients who cope with this ailment. This disease is not life threatening, but very painful. PNG prevents a person from working and sleeping, worsens the quality of life, and causes depression. It can last a year or more.
What is going on? The balance between pain and pain systems in the body is violated, this affects the functioning of the mechanism of control over the excitability of the central nervous system.
A person who is faced with such an unpleasant consequence of lumbar deprivation, treatment is prescribed. Nowadays, preference is given to drugs related to anticonvulsants. Be that as it may, the goal of therapy is to alleviate the pain and depression associated with it. Your doctor may prescribe the following:
- Antidepressants. Usually it is Amitriptyline and other modern means.
- Annoying drugs with capsaicin. The most popular is Capsicam. But it is not prescribed to everyone, only in individual cases.
- Anesthetics - Lidocaine and Benzocaine. They must be applied directly to the skin.
- Antiepileptic drugs - Pregabalin and Gabapentin.
- Painkillers - Codeine, Ibuprofen, Naproxen.
The most effective in the fight against PHN are anticonvulsants, capsaicin, opioid analgesics, patches with lidocaine, as well as tricyclic antidepressants. Modern practice has shown that other means do not give the result that is expected.
Effects
So, how to treat lumbar lichen is clear. Now we need to talk about the consequences.
If serious disorders have occurred in the immune system, then the following complications may develop:
- Problems with the brain and spinal cord. The virus has a negative feature - actively multiply in these localizations. And if it passes on to brain tissues, then they begin to collapse. This leads to paralysis of the facial nerve, upper and lower extremities. There is a risk of respiratory failure or even death of the patient.
- Meningoencephalitis. This inflammatory process is characterized by damage to the lining of the brain. Sometimes it affects the dorsal. The result is paralysis or death.
- Optic neuritis, fraught with glaucoma, damage to the cornea, or absolute blindness.
- Disturbances in the work of the abdominal muscles, lungs, duodenum, urogenital system.
And if the disease is accompanied by the addition of any bacterial infection, the patient’s condition as a whole worsens, which affects the healing process.
Prevention
About her in the end. Here are some preventative measures that you must follow:
- It is important to follow the rules of personal hygiene - use only your towel, appliances and accessories, do not wear other people's clothing.
- The patient should not be in contact with healthy people, just in case isolated from them. Not everyone had chickenpox.
- Temper in a period of full health.
- Every day, walk in the fresh air for at least 2 hours, especially during the rehabilitation period.
- Exercise, lead an active lifestyle.
- Sleep for at least 8 hours.
- Eat rationally and balanced. Try not to eat spicy, fried, canned food. Enrich the diet with foods that contain a lot of fiber.
- Take minerals, vitamins and healthy complexes.
In short, you just need to monitor your health and constantly strengthen your immune system. Especially in autumn and spring. After all, it is precisely because of problems with the immune system that shingles arise.