Herpes zoster is a viral disease that occurs with damage to the skin and nerve endings. It is characterized by severe pain and rashes on the epidermis. Pathology is caused by the same virus as chickenpox. It is more common in middle-aged and older people. This disease has other names - herpes zoster, or shingles. Each person who has had chickenpox, under adverse conditions, can get this ailment. After all, the virus remains in human cells even after complete recovery from chickenpox.
Causative agent of the disease
As already mentioned, the causative agent of herpes zoster is the chickenpox virus. In medicine, it is called the herpes virus of the third type, or Varicella Zoster (varicella zoster). This microorganism, once inside a person, remains for a long time in the neurons of the roots of the spinal cord. Therefore, only those people who have had chickenpox in the past suffer from shingles.
The mechanism of the onset of the disease is as follows:
- After chickenpox, the virus does not disappear, but remains in the body for many years. It is inactive in nerve cells.
- Under adverse conditions, the virus activates. He again becomes pathogenic.
- A person has signs of herpes zoster.
It can be said that shingles is a recurrence of chickenpox virus. The disease can occur many years and even decades after infection.
Is the disease contagious
The herpes zoster virus is easily transmitted to the surrounding airborne droplets and by contact. You can also get infected through the items that the patient used: towels, bedding and underwear, clothes. In this case, the infected person does not have herpes zoster, but chickenpox. The patient is a danger to children and adults who do not have immunity against chickenpox. It is impossible to transmit the disease in the form of shingles.
Provocative factors
At present, it is not known exactly what exactly causes the herpes zoster virus. With a strong body resistance, the pathogen can be in a "sleeping" state for a very long time. It is assumed that its activation is due to a decrease in immunity. In children under 10 years of age, shingles are not noted. Most often, the disease manifests itself after 60 years, when a person's immunity decreases with age.
The following causes of herpes zoster can be distinguished:
- diseases that lead to a decrease in immunity (chronic internal pathologies, HIV infection, tumors);
- stress
- poor nutrition;
- avitaminosis;
- hypothermia;
- course of treatment with corticosteroids or cytostatics.
We can conclude that the risk group includes people with weak immunity who have had chickenpox in the past.
Symptomatology
The disease can affect different parts of the body. Most often, the focus of rashes is localized on the trunk, less often on the face and in the ear area. In the initial stage, a person develops pain, burning and itching at the site of a future lesion. General health is disturbed, often the temperature rises. Weakness and weakness are felt. This period of the disease lasts about 1-3 days.
Then, redness, swelling and rashes appear on the lesion site. This rash is like vesicles filled with a colorless liquid. It resembles skin manifestations of chickenpox. Within 3-5 days a person has more and more rashes. So the skin signs and symptoms of herpes zoster in adults are manifested. A photo of the rash on the epidermis of a sick person can be seen below.
Then the process of bubble formation stops, their contents erupt outward. On the surface of the former rashes, a serous crust or erosion forms, which disappears after 7-14 days. Complete healing of the skin can last from 2 weeks to 1 month. Traces of the site of herpetic eruptions usually do not remain.
It is important to remember that the patient is contagious during the entire period when new vesicles form on his skin. After the rashes are covered with crusts, the patient ceases to secrete the virus and poses no danger to healthy people.
Itching with herpes zoster is expressed in varying degrees. However, this symptom always accompanies this disease. Some patients have a painful intolerable itching, which is difficult to stop. Through scratching the skin, a bacterial infection can enter the wounds, which significantly complicates the course of the disease.
The appearance of rashes is very often accompanied by severe pain. This is due to the fact that bubbles on the skin are formed along the nerve endings. Very often, the rash is localized in the area of the ribs. The virus affects not only the skin, but also the peripheral nerves. There are severe excruciating pains like neuralgia. They can radiate to the region of the heart, under the scapula, in the lower back. Unpleasant sensations usually intensify at night.
After the disease, the patient has a stable remission. Relapse of the pathology is extremely rare.
Forms of pathology
The general manifestations of herpes zoster have been described above. However, there are several varieties of this disease. Each form of this pathology is characterized by its specific symptoms. The following types of shingles are distinguished:
- Eye shape. Rashes are noted on the face along the trigeminal nerve. The disease is accompanied by severe pain. Shingles with ocular form is characterized by inflammatory processes in the organ of vision. Patients have keratitis, blepharitis, or herpetic conjunctivitis. There is redness and severe pain in the eyes.
- Ear shape. Localization of the manifestations of herpes zoster on the face is noted. The virus infects the nerve, which drives the facial muscles. Rashes are observed in the ear area, as well as in the mouth. They are very painful, the patient cannot tolerate even a slight touch on the skin. Due to damage to the facial nerve, muscle paralysis occurs on the affected side. The patient's face looks skewed. Severe pain in the ear appears, hearing is impaired. Due to a violation of the innervation of the tongue, the patient does not distinguish the taste of food. Doctors call this symptom complex Ramsay-Hunt syndrome.
- Bullous form. This kind of disease is characterized by severe skin manifestations. Rashes merge with each other and form extensive lesions. The skin is covered with large blisters that heal for a very long time.
- Generalized form. Local rashes spread over time over the entire surface of the body. A blister rash covers most of the body. This form of the disease is noted in patients with severe immunodeficiency.
- Hemorrhagic form. With this kind of pathology, the vesicles are not filled with a colorless liquid, but with bloody contents.
- Gangrenous form. In the area of the rash, tissue necrosis occurs. After healing, scars may remain on the skin.
- Meningoencephalitic form. This kind of pathology is characterized by an extremely severe course. The virus affects not only peripheral nerves, but also the brain. Severe headache, vomiting, fever, hallucinations occur. The meningoencephalitic form of the disease is extremely dangerous, it leads to death in more than half of cases.
- Erased (abortive) form. There is a rash in the form of pimples on the skin. Unlike vesicles, such rashes do not contain liquid. Skin manifestations do not last long and quickly disappear. This is the most difficult form of the disease to diagnose.
Complications
Unfortunately, patients are not always able to get off, so to speak, with little blood or a slight fear. What can patients diagnosed with herpes zoster be faced with? Complications can be quite serious. The most common consequence of the disease is postherpetic neuralgia. It is expressed in the fact that the patient retains pain in the affected areas even after complete healing of the skin. In addition, there is severe itching (in the absence of rashes), numbness, a feeling of crawling "goosebumps" on the skin. Sometimes it is very difficult to stop unpleasant sensations even with the help of strong analgesics, and you have to additionally use physiotherapeutic treatment.
In some patients, after an illness, headaches and dizziness periodically occur. With an eye and ear form of pathology, a sharp decrease in vision and hearing, as well as facial paralysis, is possible.
In extremely rare cases (about 0.2%), patients develop heart and vascular diseases that lead to ischemia.
As for the prognosis for life, the danger is the meningoencephalitic form of the disease. It can lead to the death of the patient. This form of pathology is very rare, mainly in people with sharply reduced immunity. All other types of shingles respond well to treatment and end in recovery.
Diagnostics
Diagnosis of herpes zoster is not difficult. The doctor reveals the disease during the examination. The external signs of this pathology are so characteristic that additional laboratory diagnostics are usually not required. Only in rare cases, serological tests of blood or the contents of the vesicles on the skin are prescribed.
If signs of shingles appear, consult a general practitioner (general practitioner). He will conduct an initial examination and make a diagnosis. For subsequent treatment, the patient is usually referred to an infectious disease specialist or dermatologist.
Therapies
Typically, the treatment of this disease is carried out in a clinic. However, if the patient has a bullous, generalized, or meningoencephalitic form of the disease, then placement in a hospital is indicated. Such severe types of pathology require constant medical supervision.
Therapy of shingles is aimed at solving the following problems:
- inactivation of the virus;
- relieving pain and inflammation;
- fast healing of the skin;
- increase immunity.
First of all, antiviral drugs for oral administration are prescribed:
- "Acyclovir."
- "Valacyclovir".
- "Famvir".
- "Valtrex".
Additionally, antiviral ointments are used to treat rashes: "Acyclovir", "Zovirax", "Panavir". They are applied to the affected areas in the form of compresses. However, ointments are effective only at the stage of formation of active rashes. During the appearance of crusts and at the stage of skin healing, it makes no sense to use antiviral local agents.
These drugs, for internal and local use, inhibit the reproduction of the virus. The drug "Acyclovir" (in the form of tablets and ointments) is most effective. It is the first choice in the treatment of herpes zoster in adults. A photo of the package with this medication can be seen below.
After the rash is covered with crusts, the affected areas are indicated to be treated with antiseptic solutions of brilliant green or methylene blue. This will help prevent wound infection. If there is a danger of bacteria joining, then antibiotics are used for oral administration.
If the virus affects the organ of vision, then prescribed eye drops "Interferon", "Ophthalmoferon." They have antiviral properties.
Patients with herpes zoster suffer from severe excruciating pains. Therefore, nonsteroidal anti-inflammatory drugs ("Diclofenac", "Ibuprofen", Ketanov ") or analgesics (" Baralgin "," Pentalgin ") are necessarily used in treatment. If the pain syndrome is difficult to treat and lasts for a long time, then antidepressants are additionally used: “Amitriptyline,” “Fluoxetine,” “Duloxetine,” “Venlafaxine.” In severe cases, novocaine blockades are performed.
To relieve itching, corticosteroid ointments with dexamethasone or hydrocortisone are prescribed. However, hormonal agents can be used for a very short time and with caution. These drugs reduce the immunity that the body needs to fight the virus. Therefore, with itching, antihistamines are often used: Suprastin, Claritin, Diphenhydramine. Non-hormonal ointment Fenistil gives a good effect.
An important role in the treatment of herpes zoster is played by interferon-type drugs. These are immunomodulators that mobilize the body's defenses to fight infection. Typically, with herpes, medications are prescribed: Interferon, Viferon, Galavit. Additionally, vitamins A, C and group B are used. This also helps to strengthen the immune system.
Treatment of herpes zoster in the elderly has its own characteristics. In old age, patients often have side effects from the use of drugs. Therefore, therapy should be gentle. Oral forms of antiviral drugs, if necessary, are replaced with rectal suppositories with a similar active ingredient. The course of treatment with painkillers should last no more than 5-7 days. Particular caution should be exercised when prescribing "Analgin." This tool has a toxic effect on the body of elderly patients, so during therapy, monitoring the patient's well-being is necessary.
Fast treatment with folk remedies
Is it possible to carry out effective treatment of herpes zoster at home? Quickly get rid of the virus with just one use of folk remedies does not work. This disease requires the use of medication and medical supervision. Self-medication can only lead to the development of complications.
However, you can reduce the most unpleasant manifestations of the disease using folk remedies. But their use should be agreed with the doctor. Home therapy should complement the medication for herpes zoster. The following recommendations will help to quickly stop the symptoms of the disease:
- With skin manifestations, alcohol tincture of walnut is useful. This drug can be purchased at pharmacy chains. It is applied to cotton and rubbed the affected areas three times a day.
- You can use ointment from propolis, cedar resin and wax. It can also be purchased at the pharmacy. It is sold under the trade name "Propolis Wax Cream with Cedar Gum". The ointment is applied to the rash 2 to 3 times a day.
- It is recommended to take half a day the pill "Acetylsalicylic acid." However, the use of such a tool requires a mandatory consultation with a doctor.
The use of these drugs in combination with drug therapy significantly speeds up the healing process.
Therapy reviews
You can find many different opinions about the drug treatment of herpes zoster. Reviews of treatment indicate that the best result is achieved with an integrated approach. It is far from always possible to cope with the disease by local means alone. Patients report that the simultaneous oral and cutaneous use of antiviral drugs is most effective.
Judging by the reviews, postherpetic neuralgia is most difficult to treat. Usually, pain medication in combination with antidepressants helps. Physiotherapeutic procedures have helped many patients to get rid of postherpetic pains: percutaneous electrical stimulation, electrophoresis, and UHF.
Prevention and vaccination
To prevent pathology, all people who have had chickenpox in the past should be careful about their health. It is very important to prevent a decrease in immunity. It must be remembered that the virus remains in the body and can be activated at any time. Therefore, it is important to strengthen the body's defenses, eat well and, whenever possible, avoid stress and hypothermia. Especially you need to take care of yourself to people of advanced age, because they have shingles observed most often.
Currently, the vaccine "Zostavax". This is the only shingles vaccine in the world. Vaccination is indicated for people over the age of 50-60, adults who have not had chickenpox, and patients with postherpetic neuralgia. The use of the Zostavax vaccine will help prevent an unpleasant and painful disease.