Views: 1078 Botox® or Dysport® Botulinum Toxin Type A 500U. Your rejuvenated skin with expression and naturalness. However much people care, it is normal that eventually appear on the face wrinkles, also called frown lines. Likewise, it is absolutely normal to want to eliminate to preserve a youthful appearance longer, In the correct size and with the accompaniment of a physician, that attitude only makes good. Raises self-esteem, confidence and willingness to live. One of the most successful ways to remove wrinkles is through the application of Dysport or Botox. Patients seeking treatment for rejuvenation looking to improve their appearance, considering the safety of the treatment, its practicality and ability to maintain the naturalness of facial expression. Practicality and effectiveness of a procedure that can be performed in the doctor’s office with no or little recovery time, makes BOTOX one of the more procedures performed today. * Whenever we express ourselves, we laugh or cry, facial muscles contract. As a result of these frequent contractions, with the passage of time, the activity of these muscles produce the development of deep lines such expression as forehead lines, crow’s feet, brow, among others.
* BOTOX is applied directly into the muscle responsible for the formation of the expression line wrinkle, causing its temporary relaxation and giving the face a more rested, rejuvenated and pleasing appearance. * After application, the facial expression looks more relaxed appearance, but in no way give the appearance of mascara. The overall result may be either natural. * The initial therapeutic effects is generally marked at 48-72 hours after treatment with the total duration of action of about 4 to 6 months. * Like any medical procedure, its indication must be correct and, if necessary can be combined with other techniques available against skin aging. * In cases of deeper wrinkles, the procedure fails to erase the 1st application, but mitigate ensuring better results with subsequent applications. This treatment should be applied only by a physician. Frequently asked questions How long until I see results? The results are from the second day after being applied Dysport and in the course of the day, the results will be increasingly evident. How long does the effect of Dysport? The effect of Dysport may last four to six months, depending on each patient, after which a new application to maintain or improve the initial results is recommended. Should I have many wrinkles to decide to apply Dysport?
Not necessarily. Wrinkles are marking daily, the more time passes, the more will cost you more depth and work to eliminate them. What part can apply Dysport? Wrinkles on the forehead, to bow eyebrows, crow’s feet and frown, among others. Can I feel any side effects in the application of Dysport? First it is important to know that botulinum toxin type A has been shown to be safe in numerous studies. However, some side effects can occur a few hours after application: Mild and transient head, little swelling, bruising, which can be covered with makeup, mild pain at the site of application. All these effects are temporary and reversible. Can I apply Dysport during pregnancy or breastfeeding? Like most treatments, Dysport can not be used during pregnancy or breastfeeding. Can I apply Dyposrt with other cosmetic procedures? In principle yes. Depending on the patient, the results are optimized with the combination of other procedures such as peelings, filler, lasers, among others.
Your doctor can evaluate the case and correctly oriented. ¿Dysport is only for women? No, Dysport is used in both women and men. In fact, they made gestures so strongly that cause wrinkles permanently. What should I do after application? Just follow some simple guidelines: * Do not handle (touch) the treated area. * Do not lower your head and do not lie down for a period of 6 hours * In case of small swelling and / or hematoma put compresses of ice water in the area. * Avoid physical exertion for a period of 24 hours. * You can return to normal activities immediately. What is it and who sells Dysport? Dysport is a trademark of highly purified botulinum toxin type A, with sales in more than 70 countries, marketed by Galderma in Argentina, the company world leader in dermatological research.
Dysport is a medicine that removes fine lines very quickly, allowing the site where ever someone had wrinkles or frown that seemed always furrowed, it becomes a smoother skin and a noticeably more pleasant demeanor. How does Dysport? Dysport is a medicine that is applied using small injections into specific muscles that are related to expression lines, relaxing them to avoid when making a marked expression (surprise, smile, anger, etc. ) wrinkles are evident. Will I lose the natural expression by applying Dysport? No, on the contrary, thanks to Dysport you can express all the emotions freely and naturally without causing wrinkles and without revealing age.
Videos 48. 957. Showing from # 1 Shingles (Herpes Zoster): Causes of Shingles, Symptoms and Treatment For Shingles Add to EJ Playlist Learn How To Cure Shingles Naturally Within Days Only in March. You Can Get Rid Of Shingles Fast, Safe and Permanently. 100% GUARANTEED by Thousands . . . Shingles (Herpes Zoster): Causes of Shingles, Symptoms and Treatment For Shingles DermTV – Shingles – Herpes Zoster [DermTV Epi # 425] Add to EJ Playlist Shingles, Herpes Zoster Also called, is a painful, blistering rash. And while it’s contagious, you’ll be very surprised to find out what you can catch from it.
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Herpes zoster, the “shingles”, from 10 to 20% of people who have had herpes zoster still have pain all his life. Herpes zoster is the result of the reactivation of the varicella-zoster virus. The varicella zoster virus remains dormant in the spinal ganglia after having had chickenpox. a rash appears on the skin or dermatome that is associated with herpes zoster pain. Although it is a sporadic disease incidence increases with age. 30% of patients over 55 years. Although herpes zoster is a sporadic disease in some cases between 10 and 20% develop post herpetic neuralgia (PHN) the most common complication of the disease. It is characterized by pain as burning or stinging in the area of the rash, emerges time after the onset of herpes and can last several days and sometimes months even persist over time. symptoms * Before the advent of the dermatome may have tingling and warmth in the area * The most characteristic symptom is burning, stabbing pain in the area of the rash * Rash, which is usually placed mostly in the thoracic, lumbar or cervical area. * Fever or malaise may appear
Possible complications of Herpes Zoster * -The Post-herpetic Neuralgia (between 10 to 20%) * -The Skin superinfection (2%) * Disorders ophthalmologic c omo uveitis or keratitis (1. 5%) * Neurological Disorders: Motor Neuropathies (0. 8%), asépica meningitis (0. 5%) * Disorders such as Ramsay-hunt syndrome associated with facial palsy (0. 2%) Treatment The treatment of herpes zoster has three main objectives: 1.
Treatment of acute viral infection 2. Treatment of acute pain associated with herpes zoster 3. The prevention of postherpetic neuralgia Treatment with antivirals * Shingles is treated with oral acyclovir. There are other antiviral treatments such as famciclovir or valacyclovir. Antiviral drugs are most effective when treatment is started within 72 hours after the rash. The choice of antiviral agent is personalized, and is decided by the doctor. Pain management * The pain can range from mild to severe range. Patients with mild to moderate pain may respond to conventional analgesics (paracetamol, ibuprofen, acetylsalicylic etc.
), however if the pain is severe may also require a narcotic treatment. In the use of narcotic analgesics with or without wearing a regular dosing schedule it is most appropriate for pain control. * Calamine lotions can be used in open lesions to reduce pain and itching. In lesions that have formed crust capsaicin cream (Zostrix). Lidocaine patches are also effective in reducing pain. preventive treatment * It is rare that a patient will develop shingles more than once suggesting that the recovery of the first varicella-zoster virus usually provides immune protection in the future. Studies are being conducted to evaluate the efficacy of a vaccine against varicella-zoster in the prevention or control of herpes zoster in older people. Source
What’s in this Article? (Shingles) Chicken pox used to be one of the necessary transitions of childhood. Since the appearance of the vaccine against varicella-zoster virus (VZV), most children can now prevent this infection. But it is possible that the person who has had chickenpox can get shingles; even if that person is a child. Luckily, shingles is not very common in children and adolescents with healthy immune systems. Basic description of shingles Shingles, also called “shingles” is a skin rash caused by a viral infection of the nerves that lie just under the skin. Shingles usually appears as a band of irritated skin with blisters on one side of the chest or back, but may also appear elsewhere in the body, like the face and around the eyes. Many cases of herpes zoster have mild symptoms, but severe cases can be very painful. Fortunately, both children and adolescents usually have mild cases; severe cases affect only older people. Shingles is caused by the same virus that causes chickenpox and, therefore, is highly contagious. This means it is very easy for a child pass the virus to others who are not immune to chickenpox.
This includes all those who have not had chickenpox or have not received the vaccine. However, infected with the virus, they will not develop shingles but they become infected with chickenpox. An episode of shingles usually heals itself and disappears in less than a month. While an outbreak of shingles goes away, there are treatments that can reduce the risk of complications and help your child heal faster. Causes Both shingles and chickenpox are caused by the varicella-zoster virus. This virus is related to the herpes virus that causes cold sores and genital herpes. For this reason, the condition is called herpes zoster. Once a person gets chickenpox, the virus remains in the nervous system of the person the rest of his life, even cure chickenpox. The virus remains dormant, or inactive for years. In many people, never reappears. But in about 1 million Americans a year, the virus reappears and causes shingles. You may get shingles more than once, although it is rare.
Doctors do not know for sure why outbreaks of herpes zoster after months and years of inactivity are generated. May be due to age, our immune system is weakened becoming more vulnerable to infections. This would explain why shingles is more common in older people. Children who have had chickenpox have a higher risk of getting shingles if their immune systems are weakened because of a disease such as AIDS or cancer or taking certain medications. symptoms In many cases, the first thing you notice is a tingling, itching, and sometimes pain in the area where the rash appears. This can be frustrating: The child will feel itchy, but you will have no idea what is causing it. When the rash appears finally begins as a cluster of grains on one side of the body or face. Grains turn into pus-filled blisters that open and form scabs in about 7 to 10 days. When the blisters form scabs it means they begin to heal. Scabs heal and fall about 2 to 4 weeks after the rash appears. Some children with herpes zoster develop fever, headache, fatigue, and general body aches. In very rare cases, it is possible that the child suffering from shingles have pain without rash.
Some people have more severe symptoms, but usually this occurs in people over 50 years. complications Most cases of shingles heal themselves, with or without treatment, and do not trigger other problems. In very rare cases, shingles can lead to complications such as: Continuing pain (PHN): Damage to nerve fibers in the skin send wrong messages to the brain, causing pain that may remain for long periods after the shingles has disappeared. Vision problems: If shingles appears near the eye or directly in the eye, can cause loss of sight. Skin infections: The rash of shingles can become infected with bacteria and cause impetigo or cellulitis. Nervous system problems: You may face herpes zoster may involve nerves that connect to the brain. This can cause nerve problems like facial paralysis, hearing or balance. In rare cases, shingles can cause encephalitis (brain inflammation). Diagnosis If you think your child has shingles, call a doctor. If you think your child has shingles on the face, it is vitally important that you consult a doctor immediately to prevent the infection from spreading to the eyes.
If your child has a weakened immune system, call your doctor immediately to avoid complications. Usually the doctor can diagnose shingles simply by examining the rash and blisters of the child. In rare cases, the doctor may take a sample of the infected for analysis in a laboratory tissue. Treatment Not all children who suffer from shingles require treatment. If the doctor decides that a treatment might help you improve, this should be done as soon as possible. Antiviral drugs can not eliminate the virus from the body but can reduce complications and help speed recovery. The sooner treatment begins, the more effective and run less risk of complications. Talk to a doctor about whether it is advisable that your child take medicine. To relieve the pain associated with shingles, doctors often prescribe a cream, an aerosol or a patch to numb the skin and reduce pain. There are also prescription and nonprescription pain reliever. Do not give your child aspirin because it can cause a rare but serious illness called “Reye syndrome. ”
If shingles is accompanied by itching, your doctor may recommend medications or lotions with medicines called “antihistamines”. To help relieve symptoms at home, keep the affected area clean. Wash with water and mild soap, and place wet, cold compresses on blisters several times a day to relieve pain and itching. The baths with oatmeal usually give relief. To avoid spreading the virus to others, keep the rash covered area at all times. Prevention There is no way to completely prevent shingles. The varicella vaccine can cause shingles is less serious. Therefore, if your child has not had chickenpox, it is not too late to ask the doctor to the vaccine. A vaccine against shingles, but doctors only managed to older adults. This is because the higher it is, the more severe shingles. It is very unlikely that the herpes zoster in a child is severe. Children who have a rash of shingles that can not be fully covered, should not attend school or daycare until the blisters have scabs and dry.
Newborn babies, pregnant women and anyone whose immune system is weakened, or anyone who is not immune to chickenpox should avoid contact with people suffering from shingles until the blisters have healed completely. Reviewed by: Elana Pearl Ben Joseph, MD Revision Date: March 2012 Related Links Show More Show Less Other Resources
Herpes zoster The Herpes zoster is an acute infection caused by the varicella-zoster virus. As often it affects men and women. The estimated risk of herpes zoster in the course of life is 10 to 20% and the figures increase with age, especially in people over age 60 or people with an immune system altered by disease or medical treatment. In children usually a benign process, two risk factors for zoster in childhood are recognized: maternal varicella during the second trimester of pregnancy, and chickenpox during the first year of life. In 4% of cases reappears a second outbreak of shingles. Patients at increased risk for developing this disease are patients who are with any immunosuppressive medication, uncontrolled diabetes, cancer or transplant patients mellitus. Varicella zoster virus is the cause of two different conditions. In the first contact person with the virus (primary infection) it manifests as chickenpox, a contagious and usually benign disease that affects more susceptible children. The gateway is the mucosa of the upper airways or the conjunctiva (eye) and, once the virus has entered the body, replication of the initial virus in the regional lymph nodes occurs, resulting in viremia primary that spreads the virus replication in the liver and spleen. Secondary viremia carries the virus to the dorsal root ganglia, on this site, replicate and remain dormant. At the time when the defense system under body by disease (stress, infection), the virus is activated and the reactivation of latent varicella zoster virus leads to localized rash called shingles. Skin lesions appear as “vejiguitas with water” or “blisters” that converge-like bunches of grapes on a base leaving red scabs dry.
Strip are distributed over a dermatome or skin path through which flows a nerve. You can initially start a “burning sensation” or “painful” and then skin lesions appear. The duration is usually two to three weeks. Areas where it occurs most often on the chest or back, followed by lower back, face (trigeminal) and neck. When the first division of the trigeminal is affected, the characteristic rash affects the forehead, around the eyes and nose area. The rash appears proximally and distally, spreads gradually over the affected dermatome. The area affected is unilateral and does not cross the midline; usually it affects a single dermatome, but in 20% of cases can affect up to three dermatomes. The most common complications are recurrent herpetic neuralgia or pain syndrome (pain lasting more than three months), then spread (25-50 vesicles distance of the affected territory) and bacterial superinfection. Visceral involvement is a rare complication (less than 1%). The most serious, which can even cause death, are small glass encephalitis, pneumonia or cerebral thrombotic vasculopathy. Diagnosis is based on clinical history and physical examination of the patient, which must be done by a specialist. Definitive diagnosis virus isolation in tissue samples of skin lesions is needed. Serology is conducting one of the safest methods for definitive diagnosis.
This test is used to confirm whether there are specific antibodies against varicella-zoster virus in the blood of the patient. Treatment aims to minimize pain, shorten the duration of symptoms and reduce the risk of post-herpetic neuralgia. The management of patients with herpes zoster should cover two aspects: symptomatic (whether local, systemic or both) and the administration of antiviral drugs (acyclovir) which do not receive treatment or receive it incorrectly and are at risk for complications that can cause serious functional, anatomical and aesthetic consequences. Dra. Claudia Segura Bathrooms dermatologist (CED. 6417725) Tel. 155 2300 2594 clabase@hotmail. com
Herpes zoster HERPES ZOSTER Dr. Carlos Alberto distyle Professor of Homeopathic Medicine Faculty of Medicine at Maimonides University. Lasts 24 to 48 hours. consists of paresthesia (pins and needles), more or less intense pain and heat in the area where the rash appears. There may be slight general disorders such as headache (headache), fever, asthenia (lack of energy), malaise and regional lymphadenopathy (swollen and inflamed area near the affected nodes). PERIOD OF STATE It begins with maculopapular rash consisting of elements of jagged edges, of different sizes, located in the root corresponding to the innervation, bright red area, separated by healthy skin. At 24 hs. They evolve into vesicles covering his maculopapular elements with clusters of small vesicles.
Each bouquet with vesicles with citrine content (of a liquid similar to serum), round, tense, going to the umbilicación (small depression or Pozito resembling a belly button), then the content becomes milky and after 48-72 hours . They go to desiccation. The appearance of clusters of vesicles is made successively in outbreaks. In the three days of evolution there is a rash (skin rash) covering the area of a sensory nerve innervation. In addition to healthy skin between clusters, they are small macules or papules that have not reached to evolve into the form of vesicle. There lymphadenopathy satellites, neuralgic pain in the area of a certain intensity, lightning pains of violent, stabbing etc. The evolutionary process temperature and after 5 to 7 days will desiccation of all elements, forming scabs. PERIOD DECLINE Convalescence begins with the fall of all the scabs and the appearance of the residual pigmentation. For a long time there is pain in the affected area and can be kept very intense, continuous or discontinuous, appearing sometimes by exposure to cold, mild local trauma, fatigue etc. SURVEYING OF INJURIES The thoracic segments are affected in 50% of cases. The intercostal herpes zoster is commonly known by the name of “ringworm”.
There are many popular fantasies that have no scientific hacidero and may worry that you do not know (eg . : If the shingles on one side meets the other). It is also common and regrettable that colleagues who do not know Homeopathy send these patients to healers, those who undergo the usual ink drawing, with the consequent risk of infection. Nothing is further from the reality that these beliefs that is so damaging to the population. In the elderly this disease can occur as the sign of another more serious problem, hence the importance of consultation with a professional. Ophthalmic herpes zone and otic (ear) are very serious disease locations To demonstrate the effectiveness of homeopathy in this condition I will relate a case in point. Many years ago a patient who was attending the office just to control your blood pressure (15 days ago and had been medicated for that problem) told me in passing, “Dr. I have a pretty annoying pain in the area where I Buckles bustier, you could look me see if I hurting? ” On examination, not without surprise, I discovered a rash girl with a small bouquet of three to five small vesicles characteristic of this disease. For the different types of pain, location, indicated Ranunculus Bulbosus 30 CH 5 pellets every 2 hours and with great joy within 72 hours of starting treatment had not only gone the pain, but the eruption was at its end face .
Herpes zoster Shingles is an acute infection caused by the varicella-zoster virus (VZV), which affects mostly adults. It is characterized by the development of rashes in the form of blisters or painful blisters, which are located along the course of some inflamed nerve also by the virus. Because this particular arrangement infection is popularly known as ‘ringworm’. In some Mediterranean countries is also called St. Anthony’s fire. Incidence of herpes zoster and prognosis Shingles reaches affect about 20% of the population. It can occur at any age, but most commonly appears in people over age 60 or people with immune system depleted by disease or medical treatment. In children usually a benign process, but in the case of adults can be a very debilitating disease, as it can cause great pain. In 4% of cases reappears a second outbreak of shingles. Usually it is a problem that usually persists for about a month until it disappears by itself, although they can put in place measures to treat the symptoms. However, in some immunocompromised or elderly patients, complications may occur, such as post-herpetic neuralgia, which can be disabling.
If the herpes affects the face can actually cause facial paralysis, eye problems, hearing or encephalitis. Main causes of shingles. Patients with shingles usually spread in childhood. In this first a rash illness develops (with reddish skin rash) is known as varicella, and is the initial form of infection varicella-zoster virus. After chickenpox has resolved, the virus remains dormant for years in the lymph of the dorsal nerves of the patient. The reactivation of this virus was inactivated, is the cause of shingles. the factors responsible for triggering the activation of the virus episodes are not known. It is likely that transmission of the virus occurs through the respiratory tract. It is known that chicken pox is a highly contagious disease; the patient can contaminate other people from one day before to five days after the appearance of the vesicles. Even some babies whose mothers had chickenpox during pregnancy have developed shingles during the first two years of life. Similarly, children who had chickenpox before their first year of life are more ballots to suffer this problem. In general, people with a weakened immune system, either by aging or have or have passed an infectious disease, cancer, etc. , even those who suffer episodes of high stress are more likely to develop shingles.
It has also been observed that some medications, such as some of the employees in the treatment of rheumatic diseases such as osteoarthritis could favor their appearance. Main symptoms of shingles. Symptoms of herpes zoster we can find the following: painful blisters occur along the path of a nerve (thoracic or lumbar more frequently). Usually it affects only one side of the body. These vesicles can grow for three to five days and end up joining each other, forming large blisters. This is the main symptom of shingles. Before the appearance of vesicles may arise gastrointestinal disorders, malaise, fever and headache. After pain in the affected nerve, which precedes the onset 2-3 days vesicles occurs. One of the most important manifestations of herpes zoster is postherpetic neuralgia, which can occur in up to 50% of people over age 50 and causes a permanent or intermittent pain in the affected nerve. The pain may be worse at night or with temperature changes. In some cases it becomes incapacitating, and may also be accompanied by a lack of sensitivity of the affected nerve. This is one of the most common sequelae of herpes zoster infection.
If the virus stays in cranial nerves, it may affect the eyelids and impair vision. keratitis that can be continued with glaucoma or severe iridocilitis occurs. In rare occasions, it affected the mandibular nerve. This causes lesions on the palate, tonsils, floor of the mouth and even in the language, and thus the sense of taste is lost. Like herpes simplex, you can reach the central nervous system and causarmeningitis (which cause fever, headache and stiff neck). It can potentially cause motor paralysis resulting from spinal cord infection. Other neuromuscular conditions associated with herpes zoster are: Guillain-Barré syndrome: the extremities have pain, weakness and paralysis. This picture progresses, ascending to the trunk and face. Its evolution is variable; some patients have minimal symptoms and others, however, they may require hospitalization due to respiratory muscle weakness. Finally it resolves spontaneously within weeks. Transverse myelitis: is an inflammation of the spinal cord. It manifests with motor and sensory disturbances, which then evolve paralysis of one or both legs.
In most cases the progression of symptoms is stabilized in about 10 days. There is no completely effective treatment, and recovery is never complete. Myositis: a muscle inflammation, pain involved and, if allowed to proceed, can cause necrosis. Shingles and AIDS In recent years it has been observed that shingles is a very common infection in people with AIDS. In these patients the disease occurs more aggressively than usual. The formation of lesions may last for two weeks. The total duration of the disease is usually two to ten days however, it may take two to four weeks until the skin will recover its normal appearance. Diagnosis of herpes zoster. Usually, the diagnosis of herpes zoster is based on clinical history and physical examination of the patient. Definitive diagnosis virus isolation in tissue samples of skin lesions is needed. Serology is conducting one of the safest methods for definitive diagnosis. This test is used to confirm the presence of specific antibodies against varicella-zoster virus in the patient’s blood.
A lumbar puncture will be necessary in the event that there is involvement of the nervous system to examine the spinal fluid, plus some imaging test (either CT or MRI). Treatment of herpes zoster. You can not remove the herpes zoster virus from the body by any treatment, even if you can take certain medications to relieve or reduce symptoms and recover as soon as possible. Treatment with acyclovir is accepted for chickenpox and shingles. This drug, taken orally for 7-10 days, is very beneficial for patients with a reactivation of the varicella-zoster virus. Other drugs that are also very useful comotratamiento of shingles, famciclovir and elvalacilovir are offering many advantages in terms of administration, as they require lower daily doses. If there is eye involvement, the patient should be referred to the ophthalmology department, where he was pautarán acyclovir topical and systemic treatment of your shingles In special cases, such as patients with AIDS or other immunosuppressed states, acyclovir should be used intravenously, so they always require hospitalization. Thus the possibility of further complications occur is reduced. If there herpetic neuralgia most important is the use of analgesics for pain relief. They have been used for that amitriptyline hydrochloride and fluphenazine hydrochloride. It has also been shown that early use of glucocorticoids has accelerated very significantly some aspects of improving the quality of life of patients, such as the return to normal activity and analgesic treatment discontinuation. Prevention of shingles.
In order to prevent shingles, the main thing is to avoid infection that causes chickenpox and so it is important to vaccinate all children. There is now a vaccine that is very effective and does not cause danger. People most likely to be infected with herpes zoster are members of the medical team caring for patients. Furthermore, it has been found that secretions from the airways of those affected are an important form of contagion to spread the virus from person to person through the air, so it is essential that healthcare personnel wear gloves and masks, and wash hands frequently. The administration of specific immunoglobulin to prevent infection shingles if applied within the first three days of exposure to the virus. It is indicated in patients under 15 years with no prior history of chickenpox, leukemia or other immunosuppressed states, which have been in recent contact with an infected patient. It should also protect the newborn whose mother has had chickenpox in the last 10 days before delivery. Taken: http://www. webconsultas. com/herpes-zoster/herpes-zoster-2050 Other alternative treatments: DERMASTEM DermaStem is a totally natural product.
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It is a painful, blistering rash due to the varicella-zoster virus that causes chickenpox. See also: Ramsay Hunt syndrome Causes After chickenpox, the virus remains inactive (dormant) in certain nerves. Shingles occurs when the virus reactivates in these nerves after many years. The reason why the virus becomes active again unclear. Often only one attack occurs. Shingles can develop in any age group, but one is more likely to develop the condition if: It has more than 60 years. He gave chickenpox before their first birthday. Your immune system is weakened by medication or illness. If an adult or a child have direct contact with the shingles rash and did not give them chickenpox as a child or received the chickenpox vaccine, they can develop chickenpox, not shingles. symptoms
The first symptom is usually a one-sided pain, tingling or burning. Pain and burning may be severe and usually occur before any rash appears. In most people, skin patches are formed, followed by small blisters. The blisters break, forming small ulcers that begin to dry and form scabs, which fall into two to three weeks. Scarring is rare. The rash usually involves a narrow area of the spine around the front of the ventral region or chest. The rash may involve face, eyes, mouth and ears. Other symptoms may include: Abdominal pain Fever and chills General ill feeling genital ulcers Headache
Joint pain Swollen lymph nodes Also you may have pain, muscle weakness and a rash that involves different parts of the face if shingles affects a facial nerve. Symptoms may include: Difficulty moving some of the muscles in the face Drooping eyelid (ptosis) Hearing loss Loss of eye movement Problems in the sense of taste Vision problems Exams and Tests The doctor can make the diagnosis by examining the skin and ask questions about your medical history. Rarely tests are needed, but these may include taking a skin sample to see if you are infected with the virus that causes shingles.
Blood tests may show an increase in white blood cells and antibodies against chickenpox virus, but can not confirm that the rash is due to shingles. Treatment Your doctor may prescribe a drug that fights the virus, called antiviral, which helps reduce pain, prevent complications and shorten the course of illness. It can be used acyclovir, famciclovir and valacyclovir. The drugs should be started within 24 hours of first feeling pain or burning. You better start taking them before the blisters appear. Usually medications are available in pill form and in high doses. Some people may need to be administered the drug intravenously (IV). Strong anti-inflammatory drugs called corticosteroids, such as prednisone, can be used to reduce inflammation and pain. These drugs do not work in all patients. Other medications may include: Antihistamines to reduce itching (taken by mouth or applied to the skin) Analgesics
Zostrix, a cream containing capsaicin (an extract of pepper) that can reduce the risk postherpetic deneuralgia They can be used wet and cold compresses to reduce pain. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion can help relieve itching and discomfort. It also recommended rest in bed until the fever goes down. Keep your skin clean. Do not reuse contaminated items. Wash non-disposable items in boiling water or disinfect before reuse. It may be required to stay away from people while lesions are oozing to prevent infection who have never had chickenpox, especially pregnant women. Forecast Shingles usually disappears in two or three weeks and rarely recurs. If the virus affects the nerves that control movement (motor nerves), you may feel weak or temporary or permanent paralysis. Sometimes the pain in the area where it occurred shingles can last from months to years, which is called post-herpetic neuralgia. PHN is more likely to occur in people over 60 years and occurs when the nerves have been damaged after an outbreak of shingles.
The pain ranges from mild to very severe. complications Complications may include: Another attack of shingles Bacterial skin infections Blindness (if shingles occurs in the eyes) Deafness Infection, including encephalitis or sepsis (blood infection) in people with weakened immune systems Ramsay Hunt syndrome if shingles affects the nerves in the face Call your provider Talk with your doctor if you have symptoms of shingles, particularly if you have defenses or if symptoms persist or worsen. Shingles that affects the eye can lead to permanent blindness if you do not receive emergency medical care. Prevention
Avoid contact with skin rashes and blisters of persons with shingles or chickenpox if you have never had chickenpox or have not been vaccinated against this disease. Availability of a vaccine against herpes zoster and is different from the chickenpox vaccine. Older adults who get the vaccine against shingles are less likely to have complications from the disease.
Herpes zoster (shingles) on the neck and cheek Herpes zoster (shingles) in the chest Herpes zoster (shingles) on the back classic pattern of herpes zoster (shingles). Infection follows the path of a nerve root from the spine, along a rib, to the front of the chest. The innervated by the nerve area is called “dermatome”. It is a painful, blistering rash due to acute infection with varicella zoster virus that causes chickenpox. Causes and risk factors After chickenpox, the virus remains inactive (dormant) in certain nerves. Shingles occurs after the virus reactivates in these nerves after many years. The reason why the virus becomes active again unclear. Often only one attack occurs.
If an adult or child is exposed to the herpes zoster virus and has not had chickenpox as a child or have not been vaccinated against this disease, you may develop a severe case of chicken pox rather than shingles. Shingles can be contagious through direct contact in an individual who has not had chickenpox, and therefore has no immunity. Shingles can affect any age group, but is much more common in adults over 60 years in children who had chickenpox before one year of age and in individuals without defenses. symptoms The first symptom is usually a one-sided pain, tingling or burning. Pain and burning may be severe. skin patches are formed, followed by small blisters that look very similar to the initial chickenpox. The blisters break and form small ulcers that begin to dry and form scabs, which fall into two to three weeks. The rash usually involves a narrow area of the spine around the front of the belly area or chest. It may involve face, eyes, mouth and ears. Additional symptoms may include: * Abdominal pain * Shaking chills
* Difficulty moving some of the muscles in the face * Droopy eyelid (ptosis) * Fever * General ill feeling * Genital lesions * Headache * Hearing loss * Joint pain * Loss of eye motion (ophthalmoplegia) * Swollen lymph nodes * Abnormalities in taste Signs and tests The doctor can make the diagnosis by examining the skin and asking questions about your medical history.
Rarely tests are needed, but may include taking a skin sample to see if you are infected with the virus that causes shingles. Laboratory tests may show an increase in white blood cells and antibodies against chickenpox virus, but can not confirm that the rash is due to shingles. Treatment Shingles usually disappears spontaneously and only need treatment to relieve pain. The doctor may prescribe an antiviral drug called acyclovir, which helps reduce pain and complications, as well as shorten the course of illness. Desciclovir, famciclovir, valaciclovir and penciclovir are similar to acyclovir and can also be used. The drugs should be started within 24 hours of feeling pain or burning and preferably before the blisters appear. Usually, much higher drugs are supplied in tablet form in doses recommended for simple herpes or genital herpes. Some people may need to be administered the drug intravenously (IV). Strong anti-inflammatory drugs called corticosteroids, such as prednisone, can be used to reduce inflammation and the risk of continued pain. These drugs do not work in all patients. Other medications may include: * Antihistamines to reduce itching (by mouth or applied to the skin)
* Analgesics * Zostrix, a cream containing capsaicin (an extract of pepper) to prevent post-herpetic neuralgia They can be used wet and cold compresses to reduce pain. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion can help relieve itching and discomfort. It also recommended rest in bed until the fever goes down. You should keep your skin clean and not reuse contaminated items. Similarly, non-disposable items should be washed in boiling water or otherwise disinfected before reuse. The person may need to be isolated while lesions are oozing to prevent infecting others, especially pregnant women. Expectations (prognosis) Shingles usually disappears in two or three weeks and rarely recurs. If the virus affects the nerves that control movement (motor nerves), you may feel weak or temporary or permanent paralysis. Sometimes the pain in the area where shingles occurred may last from months to years. This pain, called postherpetic neuralgia, can be extremely intense.
The elderly are at greatest risk of this complication. complications The commitment of the facial nerve may cause Ramsay Hunt syndrome, which can lead to loss of movement in the face, hearing loss, loss of sense of taste and other symptoms. Other complications may include: * Another attack of shingles * Blindness (if lesions in the eye) * Deafness * Infection, lesions in body organs, encephalitis or sepsis in people with weakened immune systems * Postherpetic Neuralgia * Skin, bacterial infections and secondary Call your health care Talk with your doctor if you have symptoms of shingles, particularly if you have defenses or if symptoms persist or worsen. Shingles that affects the eye can lead to permanent blindness if you do not receive emergency medical care.
Prevention Avoid contact with rash and blisters of persons with shingles or chickenpox if you have never had chickenpox or has not made the vaccine against this disease. The varicella vaccine may be recommended for teenagers or adults who have never had chickenpox. Medical evidence has shown that older adults who get the vaccine are less likely to have complications from shingles. Adults over 60 years should receive the vaccine as part of routine medical care.
Herpes zoster Classification and external resources Blisters characteristics of shingles ICD-10 B02 ICD-9 053 Medline Search Medline (in English) MedlinePlus herpes zoster + Synonyms shingles
Shingles is a reactivation of the chickenpox virus characterized by small painful blisters ring-shaped clustered along a dermatome. Colloquially, it is more commonly known as shingles or culebrina, and in some areas of the Mediterranean, such as Italy and Malta, is known as “St. Anthony’s Fire. ”  Shingles is actually neuropathy, affecting peripheral nerves with or without cutaneous manifestations. //
5 times higher in Caucasians than in Hispanics.  can also occur in individuals of other groups, under severe emotional stress.  Etiology Shingles is caused by the varicella zoster virus (VZV). This is a virus of the family of herpesviruses (Herpesviridae); in particular it is classified as HHV-3 or “human herpes virus 3”. VZV is also the cause of chickenpox, skin disease classically child. Therefore, you must have been exposed to chickenpox to develop a herpes zoster. Pathogeny Most people connect with VZV during childhood, though not always have chickenpox (because they have a subclinical picture). The immune system eliminates the virus from the body, although it remains dormant in the nerve ganglia (dorsal root ganglia, off the nerves of the spinal cord). Also it remains dormant in nerve ganglia other body, such as trigeminal ganglion Gasser or other cranial nerves in the head. the immune system usually keeps the virus inactive.
When it deteriorated (with certain diseases, age . . . ) the virus reactivates and replicates in neurons, and form new viruses circulating along the axon to the area of skin innervated by that node (dermatome). Once there, the virus can cause inflammation of the skin blistering.   The characteristic pain of shingles is caused by irritation of sensory fibers in the infected nerve. Numerous factors have been described as possible or probable triggers reactivation of VZV. All are related to a decreased ability to continue maintaining immune dormant virus system. Among these factors are age, severe emotional stress, serious illness, immunosuppression, and corticosteroid therapy. However, the pathogenic events leading to the revival are still little known.  There have been cases of exacerbations also due to skin damage such as puncture, scratching or biting on more sensitive skin areas such as the nipples, ears and armpits.  Clinic
The prodromal symptoms of shingles include headaches, photosensitivity, fever and malaise, which may last one or several days. Follow from itching, tingling and pain that can be extreme, all in the area of the affected nerve, where the rash appears. This pain can have multiple features, such as stinging, burning, spicy . . . and usually develops in acute flare-ups and exacerbations. At this stage, there may be diagnostic problems with other diseases, including myocardial infarction or renal colic, according to the affected area. Some patients may have these symptoms and do not develop the rash, which is called “zoster sine herpete” which can make diagnosis difficult.  The subsequent phase is the development of characteristic skin rash. The lesions begin as erythematous spots passing blisters on dermatomes, commonly in a pattern that simulates a belt without passing the midline of the body. Not usually affected more than three metameres. The most common regions are the midchest (from D3 L2) and the ophthalmic area of the face, which may have an impact on vision.
  The vesicles are transformed into blisters filled with a serous fluid they are generally dolosorosas and are accompanied by anxiety and flu-like symptoms (fever, fatigue and widespread pain. Occasionally, the content of the vesicles may be hemorrhagic (bloody), and explode within 7 to 10 days. When this happens , resolve with scarring and hyperpigmentation.  Blisters are contagious by direct contact (generally within 7 days) and can pass from one person to another. If the VZV passes from a person with shingles to someone who has never had contact with the virus, the picture that produces it is a chicken pox. The virus is not spread through breathing, coughing or casual contact. Therefore, only infectious disease in bullous phase, and not in the prodromal, cicatricial or postherpetic phases.   Diagnosis The diagnosis is eminently clinical. Very few diseases require a differential diagnosis, due to the peculiar location of the rash. Among them include the special effects of contact with poison sumac and poison ivy (although they itching is particularly intense).
If in doubt, exisen a series of additional tests. They may be necessary because prior to the onset of the rash pains can generate errors diagnoses with pleurisy, acute myocardial infarction, appendicitis, cholelithiasis or migraines, depending on the location. Samples may be taken vesicle fluid in which cells infected with VZV have an elongated and dark cell nucleus. Can Viral culture from a fresh injury or microscopic examination of the base of the blister, called Tzanck preparation. In the blood count, there may be leukocytosis as an indirect sign of infection, and elevated antibodies against VZV.  Treatment Currently, no curative treatment, or possible elimination of the organism virus. However, there are treatments that can alleviate the symptoms and reduce the duration and severity. antiviral drugs Acyclovir (Zovirax ®) inhibits viral DNA replication, and therefore used as a treatment, as prevention (for example, AIDS patients) . Other antivirals are used valacyclovir (Valtrex ®) and famciclovir (Famvir ® ). During the acute phase, acyclovir orally is recommended, as it has been shown as the most effective drug to slow the progression of symptoms, and prevent post-herpetic neuralgia whenever the pattern is started in the first 24 to 72 hours.
Immunosuppressed patients may also respond to intravenous acyclovir. In patients at high risk of recurrence, an oral dose of acyclovir twice a day, usually effective.  has also been shown that the use of the amino acid lysine inhibits replication of VZV.  other drugs (1996) Efficacy of cimetidine in treatment of herpes zoster in the first 5 days from the moment of disease manifestation. Pol Tyg Lek. 51 (23-26): 338-339. 88576. ISSN 0860 Accessed September 6, 2007. In English.   On the other hand, has shown that cimetidine and probenecid reduce the renal clearance of acyclovir.  Studies have shown that these drugs reduce the degree (but not all) of valacyclovir acyclovir metabolism.
The clearance of acyclovir was reduced by approximately 24% and 33% respectively with each drug, and increased peak plasma levels of acyclovir by 8 and 22%. The study authors concluded that “it is not expected that these effects have clinical consequences on the effects of valaciclovir compared to their safety. ” Because of the tendency of aciclovir to precipitate in the renal tubules, combining these drugs should be undertaken with caution, especially in patients with renal insufficiency. complementary therapies Some therapeutic options such as digestive enzymes were used before the era of antiviral. Pancreatic enzymes were a therapeutic option in several countries, and conducted multiple research. A large multicenter clinical trial has recently shown promising results.   The results of other clinical trials support the idea that oral enzyme therapy is beneficioa in patients who also have pathologies with increased production of factor tumor-beta (TGF-β) growth.  on the other hand, has found increased levels in patients TGF-β VZV.   Forecast The rash and pain usually persist for 3-5 weeks. Many patients develop a chronic painful condition called post-herpetic neuralgia, difficult to treat.
This is more common in the elderly, and can get to incapacitate the patient, given its severity. In some patients, shingles can react subclinical, with pain dermatome without more complicated and affecting more nerves than the initial signs cutaneous herpes zoster (zoster sine herpete). Moreover, in these cases can be complicated by cranial neuropathy, polyneuropathy, myelitis, or aseptic meningitis. In the case of herpes facial zoster, can cause complications such as facial paralysis, usually temporary, decreased hearing or encephalitis (in the so-called Ramsay-Hunt syndrome, involvement VII and IX cranial nerves. The perioftálmico zoster ( affectation of the first branch of the trigeminal) requires urgent eye care, as it can derive the eye, such as mucopurulent conjunctivitis, episcleritis, keratitis and anterior uveitis complications. there may be paralysis of cranial nerves III, IV and VI, resulting in impairment of movement eyepiece.  A complication potentially serious, but rare, is respiratory failure due to diaphragmatic paralysis, in case of involvement of the vagus nerve or cranial nerve X. Other complications that occur mostly in immunosuppressed individuals are necrotic shingles (with deep and necrotic ulcers, which can lead to bacterial infection); and widespread herpes zoster (in which multiple lesions occur in the affected distance, with hematogenous spread metamere). Prophylaxis Zostavax ® is a vaccine developed by Merck \x26amp; Co. , whose effectiveness has been proven to prevent 50% of cases of shingles in a study of 38,000 patients.  In the same study also reduced post-herpetic neuralgia two-thirds.
 However, prior to vaccine development that adults could acquire natural immunity through contact with children with chickenpox (which helped decrease the reactivation of herpes zoster) is known. [ 17]  the efficacy of the vaccine itself depends on exogenous trigger mechanisms. Therefore, fewer cases of chickenpox in turn reduces the effectiveness of the vaccine.  The intake of micronutrients such as antioxidant vitamins (vitamin A, C, E) or vitamin B, as well as fresh fruit consumption can reduce the risk of shingles. A study in which a group of patients drank less than one serving of fruit daily showed a risk three times higher than shingles than the group that consumed more than three daily servings. This effect was also visible for people over 60 years.  Another recent study evaluated the effects of two types of behavioral intervention, Tai Chi and health education, healthy adults. These, after 16 weeks of intervention, were vaccinated with VARIVAX ® (an attenuated version of the vaccine developed by Oka / Merck). The result was a significant demonstration of the effectiveness of Tai Chi (especially in combination with the vaccine) on the educational method.  See also herpesvirus
Chickenpox Bibliography Ferrandiz, C . : “virus infections. ” Clinical Dermatology. Madrid: MMI Elsevier Spain, S. A. , 1996. ISBN 8481745375 References ↑ abcd Zamula, E. (2005). Shingles: An Unwelcome Encore.
Administration Food and Drug US. Last accessed on September 6, 2007. In English. ↑ abc Oxman, MN. , Levin MJ. , Johnson GR. , Et al. (2005). A vaccine to Prevent postherpetic neuralgia and herpes zoster in older adults. N Engl J Med 253 (22): 2271-2284. ISSN 1593 0418. Accessed September 6, 2007. In English.
↑ ab Donahue, JG. , Choo, PW. , Manson, JE. , Platt, R. (1995). The incidence of herpes zoster. Arch Intern Med 155 (15): 1605-1609. ISSN 0003 9926. Accessed September 6, 2007. In English. ↑ Chaves SS. , Santibanez TA. , Gargiullo P.
, et al. (2007). Chicken pox and herpes zoster exposure disease incidence in older adults in the U. S. Public Health Rep 122 (2). ISSN 1735 7357. Accessed September 6, 2007. In English. ↑ SK Mehta. , Cohrs RJ. , Forghani B. , et al. (2004).
Stress-induced subclinical reactivation of varicella zoster virus in astronauts. J Med Virol 72 (1): 174-179. ISSN 1463 5028. Accessed September 6, 2007. In English. ↑ abcdefg Stankus, SJ. , Dlugopolski, M. , Packer, D (2000). Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia. Am Fam Physician 61 (8): 2437-2447. ISSN 1079 4584. Accessed September 6, 2007. In English.
↑ ab Johnson, RW. , Dworkin, RH. (2003). Clinical review: Treatment of postherpetic neuralgia and herpes zoster. BMJ 326 (7392): 748. ISSN 0959 8138. Accessed September 6, 2007. In English. ↑ Griffith, RS. , Walsh. , Myrmel KH. , Et al. (1987).
Success of L-lysine therapy in recurrent herpes simplex infection faq frequently. Treatment and prophylaxis. Dermatologica 175 (4): 183-190. ISSN 0011 9075. Accessed September 6, 2007. In English. ↑ Hayne ST. , JB Mercer. (1983). Herpes zoster: With cemetidine treatment. Can Med Assoc J 129 (12): 1284-1285. ISSN 0008 4409. Último access on 6 September 2007.
In English. ↑ Notmann J. , J. Arieli, Hart J. , et al. (1994). In vitro cell-mediated immune reactions in herpes zoster Patients Treated With cimetidine. Asian Pac J Allergy Immunol 12 (1): 51-58. ISSN 0125 877X. Last accessed on September 6, 2007. In English. ↑ F. De Bony, Tod M.
Bidault R. , et al. (2002). Multiple interactions of cimetidine and probenecid With valaciclovir and Its metabolite acyclovir. Antimicrob Agents Chemother 46 (2): 458-463. ISSN 1532 0227. Accessed September 6, 2007. In English. ↑ Billigmann P. (1995). Enzyme therapy-an alternative in treatment of herpes zoster. A controlled study of 192 Patients. Fortschr Med 113 (4): 43-8.
ISSN 0015 8178. Accessed September 6, 2007. In English. Original article in German. ↑ Roxas M. (2006). Postherpetic neuralgia and herpes zoster: diagnosis and therapeutic considerations. Altern Med Rev 11 (2): 102-13. ISSN 1089 5159. Accessed September 6, 2007. In English. ↑ L. Desser, D.
Holomanova, Zavadova E. , et al. (2001). Oral Therapy With proteolytic enzymes decreases excessive TGF-beta levels in human blood. Chemother Pharmacol 47 Suppl Cancer: S10-5. ISSN 0344 5704. Accessed September 6, 2007. In English. ↑ Kaygusuz I. , Gödekmerdan A. , Keleş E. , et al. (2004).
The role of viruses in peripheral idiopathic facial palsy and cellular immune response. Am J Otolaryngol 25 (6): 401-6. PMID ISSN 0196 0709. Accessed September 6, 2007. In English. ↑ M. Sato, Abe T. , Tamai M. (2000). Expression of the Varicella Zoster Virus Thymidine Kinase and Cytokines in Patients With Acute Retinal Necrosis Syndrome. Jpn J Ophthalmol 44 (6): 693. ISSN 0021 5155. Accessed September 6, 2007.
In English ↑ M. Brisson, Gay N. , W. Edmunds et al. (2002). Exposure to varicella boosts immunity to herpes zoster: Implications for mass vaccination Vaccine Against chicken pox . . 20 (19-20): 2500-7. ISSN 0264 410X. Last accessed on September 6, 2007. In English. ↑ In Massachussetts, massive vaccination campaign against chickenpox carried out between 1999 and 2003 increased the incidence by 90%, from 27.
7 to 52. 5 cases per 100,000 population per year. Yih, WK. , Brooks DR. , SM Lett. , Et al. (2005). The incidence of varicella and herpes zoster in Massachusetts as Measured by the Behavioral Risk Factor Surveillance System (BRFSS) During a period of increase increasing varicella vaccination coverage, 1998-2003. BMC Public Health 5 (1): 68-68. ISSN 1471 2458. Accessed September 6, 2007. In English. ↑ Goldman, GS.
(2005). Universal varicella vaccination: efficacy trends and effect on herpes zoster. Int J Toxicol 24 (4): 205-213. ISSN 1091-5818. Last accessed on September 6, 2007. In English. ↑ Thomas SL. , Wheeler JG. , AJ Hall. (2006). Micronutrient intake and the risk of herpes zoster: a case-control study. Int J Epidemiol 35 (2): 307-14. ISSN 1464-3685.
Last accessed on September 6, 2007. In English. ↑ Irwin, MR. , Olmstead, R. Oxman, MN. (2007). Augmenting Immune Responses to Varicella Zoster Virus in Older Adults: A Randomized, Controlled Trial of Tai Chi. J Am Geriatr Soc 55 (4): 511-517. ISSN 1532-5415. Last accessed on September 6, 2007. In English. Wikipedia
INTRODUCTION The International Society for the Study of Pain defines neuropathic pain as “pain initiated or caused by a primary lesion or dysfunction of the nervous system due to alterations of central or peripheral nervous”. This disorder can be produced by compression, transection, infiltration, ischemia or metabolic injury to neuronal cells or a combination of these factors CLASSIFICATION The traditional classification of neuropathic pain is based on the underlying pathology (p. Eg. Diabetic neuropathy, trigeminal neuralgia, post-herpetic neuralgia, pain caused by spinal injury, etc. ) as well as in the location of the suspected nerve injury (peripheral or central). Another classification is based DIAGNOSIS The separation stimulation symptom is one of the reasons why it is difficult to diagnose neuropathic pain. To be strict definition, the doctor should prove the existence of an injury or nerve dysfunction to diagnose neuropathic pain. For this reason, the diagnosis of neuropathic pain should take into account the complete medical history of the patient with an exhaustive clinical and neurological examination.
The medical history will determine the start, the location and distribution of pain and possible association thereof to a trauma. Moreover, the description of pain (stinging, burning, diffuse, etc. ) as well as the examination of the affected areas to identify possible sensory deficits by some instruments (cold or hot to determine the thermal sensitivity rollers, brush camel hair for tenderness or a sharp object to determine sensitivity to pain) will determine an injury or nerve dysfunction TREATMENTS There is no treatment to prevent neuropathic pain or to predict properly surgical decompression Local treatments: transcutaneous electrical stimulation (TENS) massage (Hot / cold) heat treatments acupunctura Lock Jaipur Central nerve stimulation
Spinal cord stimulation Deep brain stimulation drugs anticonvulsants antidepressants tricyclic antidepressants (amitriptyline, nortriptyline, etc) selective inhibitors of serotonin reuptake (sertraline, paroxetine, citalopram, etc) Analgesics Paracetamol Non-steroidal anti-inflammatory opiates Anaestesicos: local anesthetics
blocking nerve epidural anesthesia ketamine other treatments Psychological therapies Rehabilitation Hypnosis Alternative medicine N. Attal, G. Cruccu, M. Haanpää, P. Hansson, T.
S. Jensen, T. Nurmikko, C. Sampaio, S. and P. Wiffen Sindrup GUM. EFNS guidelines on pharmacological treatment of neuropathic pain. European Journal of Neurology, Volume 13, Issue 11, Page 1153-1169 Merskey H, Bogduk N, eds. Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. 2nd ed. Seattle, IASP Press; 1994. Barolat G .
. Spinal Cord Stimulation for Chronic Pain Management. Arch Med Res 2000; 31 (3): 258-62 Weintraub MI, Wolfe GI, Barohn RA, et al. Static magnetic field therapy for symptomatic diabetic neuropathy: a randomized, double- blind, placebo-controlled trial. Arch Phys Med Rehabil 2003; 84: 736-46 . . Abuaisha BB, JB Costanzi, Boulton AJ. Acupuncture for the treatment of chronic painful diabetic peripheral neuropathy: a long-term study. Diabetes Res Clin Pract 1998; 39: 115- 21. Tawata M, Kurihara A, Nitta K, Iwase E, Gan N, Onaya T. The effects of goshajinkigan, a herbal medicine, on Subjective symptoms and vibratory threshold in Patients With diabetic neuropathy. Diabetes Res Clin Pract 1994; 26: 121- 8.
It is a disease caused by a virus called varicella zoster. The first time that this virus attacks a person causes chickenpox. After chickenpox virus remains dormant in the body. Most people do not notice because the virus does not cause them any disease. However, sometimes the virus is activated and causes burning sensation or pain in any area of the skin, redness and blisters: the herpes zoster. Not to be confused with cold sores, which is produced by another type of virus. What can you do? To dry the blisters, apply a lotion with copper powder or zinc sulfate. Prepare this lotion mixing 1 g of copper sulfate or zinc sulfate buy at the pharmacy with 1 liter of tap water. Soak a cloth or pad with lotion and place for 10 minutes on the blisters. Reapply 3 times per day until the blisters are dry and are scabs. Probably you need to make 1 l lotion every day. The blisters can spread the chickenpox virus to people who have not yet passed.
To avoid this, wash your hands if you have touched injuries. If people around you have had chickenpox, there is no risk of contagion. Wear comfortable clothes that do not bother to slide skin. If you have pain, you can relieve it with medicines such as paracetamol. Most of the time the shingles heals without complications with this care. When talking to your family doctor? If you think you have a herpes zoster, consult your doctor to confirm the diagnosis and assess the treatment you need. Most of the time will be enough to care commented, but there is a treatment with pills used in some cases: If you are older than 50 years. If you are diabetic. If you have low defenses. If herpes has left him in the head or face. Treatment with pills for these cases is only effective when it begins to take during the first 3 days of illness.
It is therefore important to go soon to the query. You should see your doctor again: If you go more blisters on other parts of the body. In this case, it may be necessary to be treated in hospital. Keep an eye on healthy skin, especially during the first few days. If there are no yellow crusts and heal. It is likely to have been infected and require antibiotic treatment. If the pain does not go away after the blisters heal. The persistence of pain when herpes has already been cured is more common in older people. There is a treatment to relieve it. Information extracted from the Spanish Society of Family and Community Medicine. http://guiapractica. semfyc.
For a person to develop VZV infection, you must first have had chickenpox and, after a long period of numbness of the virus, the virus can reactivate and make way for an outbreak of shingles. Many people develop chickenpox at some point in their lives, usually in childhood, but can also occur at any other age. Although lesions in the skin heal, the virus remains in nerve roots near the spinal cord of infected persons, latent or inactive way. When activated, it spreads along the nerve tract, first causing pain or burning sensation. VZV is not transmitted to another person who has already had chickenpox or been vaccinated to prevent disease. However, someone who has not had chickenpox or been vaccinated can not develop chickenpox if in contact with a person with an outbreak of herpes. Causes While the cause of reactivation is usually unknown, shingles can occur following a deterioration of the immune system. Aging is also associated, as well as stress or any other that may alter the body’s defenses. VZV in people with HIV Among the general population, 3% to 5% of people with VZV can develop shingles at some stage of their lives. However, according to some estimates, among people with HIV, the chances are between 15 and 25 times higher, and can occur even if CD4 levels are not too low. In addition, people with HIV whose immune system is very weak, ie, with a CD4 count below 50, increase the risk that, once developed, infection with herpes zoster compromise other parts of the body, such as retinal; which can lead quickly to blindness, which could be permanent if not treated early.
symptoms Shingles symptoms appear, usually without notice and begin with a burning sensation, stabbing pain, tingling or numbness in the affected area. Some people feel a strong itching or discomfort rather than pain. Others also may have also fatigue, fever, chills, headache and upset stomach. The typical rash appears VZV two or three days after the virus leaves the nerve roots. It is characterized by the appearance of red spots on the skin with small vesicles (blisters), which are very similar to those of the initial phase of chickenpox. Often the rash is maximized between three and five days, after which the blisters break forming small ulcers that ooze and then dried crusting, ending shedding in the next two or three weeks and leave the skin pink in healing process. Injuries may take longer to dry in those with HIV whose immune system is weakened. They usually appear more frequently in the back, in the upper abdomen or face. Treatment Although it can be uncomfortable and even cause severe pain, their symptoms are treatable. Prevent the spread of infection, reduce pain and prevent the area becoming infected with bacteria are treatment goals. Mild and small lesions can be treated with ointment (acyclovir), but often is most appropriate treatment based tablets (acyclovir, valacyclovir, famciclovir).
In more serious cases, intravenous administration, which may involve hospitalization may be necessary. For the oral treatment work better, you should start taking it within the first 72 hours of the onset of skin lesions, so it is important that if you get to feel any of the symptoms described, you contact your GP immediately to start the medication as soon as possible. Sources: Aidsmap and HIV-iBase (HONcode certified entity) (certified by The Information Standard, belonging to the British National Health Service [NHS] Entity).
(Shingles) Chicken pox used to be one of the necessary transitions of childhood. Since the appearance of the vaccine varicella-zoster virus (VZV), most children can now avoid this infection. But it is possible that the person who has had chickenpox can get shingles; even if that person is a child. Luckily, shingles is not very common in children and adolescents with healthy immune systems. Basic description of herpes zoster Shingles, also called “shingles” is a skin rash caused by a viral infection of the nerves that lie just under the skin. Shingles usually appears as a band of irritated skin with blisters on one side of the chest or back, but may also appear elsewhere in the body such as the face and around the eyes. Many cases of herpes zoster have mild symptoms, but the most severe cases can be very painful. Fortunately, both children and adolescents usually have mild cases; severe cases only affect elderly people. Shingles is caused by the same virus that causes chickenpox and, therefore, is highly contagious. This means it is very easy for a child pass the virus to others who are not immune to chickenpox. This includes all those who have not had chickenpox or have not received the vaccine.
However, infected with the virus, herpes zoster not contract the disease from spreading but with chickenpox. An episode of shingles usually heals itself and disappears in less than a month. While an outbreak of herpes zoster disappears alone, there are treatments that can reduce the risk of complications and help your child heal faster. Causes Both herpes zoster and chickenpox are caused by the varicella-zoster virus. This virus is related to the herpes virus that causes cold sores and genital herpes. For this reason, the condition is called herpes zoster. Once a person gets chickenpox, the virus remains in the nervous system of the person the rest of his life, even cure chickenpox. The virus remains dormant, or inactive for years. In many people, never again reappear. But about 1 million Americans a year, the virus reappear and cause shingles. It is possible to get shingles more than once, although it is rare. Doctors do not know for sure that outbreaks of herpes zoster after months and years of inactivity are generated.
May be due to age, our immune system is weakened by becoming more vulnerable to infections. This would explain why herpes zoster is more common in older people. Children who have had chickenpox have an increased risk of herpes zoster if their immune systems are weakened because of a disease such as AIDS or cancer or taking certain medications. symptoms In many cases, the first thing you notice is a tingling, itching, and sometimes pain in the area where the rash will appear. This can be frustrating: The child will feel itching, but you will have no idea that is causing. When the rash appears finally begins as a cluster of grains on one side of the body or face. Grains turn into pus-filled blisters that open and form scabs in about 7 to 10 days. When the blisters form scabs it means they begin to heal. Scabs heal and fall about 2 to 4 weeks after the rash appears. Some children with herpes zoster develop fever, headache, fatigue, and general body aches. In very rare cases, it is possible that the child suffering from herpes zoster feel pain without rash. Some people will have more severe symptoms, but usually this occurs in people over 50 years.
complications Most cases of herpes zoster heal themselves, with or without treatment, and do not trigger other problems. In very rare cases, shingles can lead to complications such as: Continuing pain (PHN): The damage to nerve fibers in the skin send wrong messages to the brain, causing pain that may remain for long periods after that herpes zoster is gone. Vision problems: If shingles appears near the eye or directly into the eye, can cause a loss of vision. Skin infections: herpes zoster rash can become infected with bacteria and cause impetigo or cellulitis. Nervous system problems: It is possible that herpes zoster may involve facial nerves that connect to the brain. This can cause nerve problems such as facial paralysis, hearing or balance problems. In rare cases, shingles can cause encephalitis (inflammation of the brain). Diagnosis If you think your child has herpes zoster, call a doctor. If you think your child has herpes zoster in the face, it is vitally important that you consult a physician immediately to prevent the infection from spreading to the eyes. If your child has a weakened immune system, call the doctor immediately to avoid complications.
Usually the doctor can diagnose herpes zoster simply by examining the rash and blisters of the child. In exceptional cases, the doctor may take a sample of the infected for analysis in a laboratory tissue. Treatment Not all children who suffer from shingles require treatment. If the doctor decides that a treatment might help you improve, this should be done as soon as possible. Antiviral drugs can not eliminate the virus from the body but can reduce complications and help speed recovery. The earlier the treatment, the more effective and less risk of complications will run begins. Talk to a doctor to know if it is recommended that your child take medicine. To relieve the pain associated with shingles, doctors usually prescribe a cream, an aerosol or a patch to numb the skin and reduce pain. There are also prescription and nonprescription pain reliever. Do not give your child aspirin because it can cause a rare but serious illness called “Reye syndrome. ” If shingles is accompanied by itching, the doctor may recommend medications or lotions with “antihistamine” drugs called.
To help alleviate symptoms at home, keep the affected area clean. Wash with water and mild soap, and place wet, cold compresses on blisters several times a day to relieve pain and itching. The baths with oatmeal usually give relief. To avoid spreading the virus to others, keep the rash covered area at all times. Prevention There is no way to completely prevent herpes zoster. The varicella vaccine can cause shingles is less serious. Therefore, if your child has not had chickenpox, it is not too late to ask the doctor to the vaccine. A vaccine against herpes zoster, but doctors only managed to seniors. This is because the higher you are, the more severe the shingles. It is very unlikely that herpes zoster in a child is severe. Children who have a rash of shingles that can not be fully covered, should not attend school or daycare until the blisters have scabs and dry. Newborn babies, pregnant women and anyone whose immune system is weakened, or anyone who is not immune to chickenpox should avoid contact with people suffering from herpes zoster until the blisters have healed completely.
Reviewed by: Elana Pearl Ben Joseph, MD Revision Date: March 2012
Virions human herpes group 3 (Varicellovirus or varicella virus) virus are constituted by a cover, one integument, a nucleocapsid and core. Virions are between 120 and 200 nm in diameter and are spherical or pleomorphic. The cover shows numerous small projections that cover almost completely. Tegument proteins are unstructured and form asymmetrical layers located between the cover and the capsid. The latter, spherical, has a icohexahédrica symmetry, the arrangement being perfectly visible capsomeres. 162 in number, capsomeres are arranged in a hexagonal structure with a central passage extending partway of the major axis. The core is formed a network of fibrils DNA of which one end is anchored to the inside of the capsid. Capsids easily taken while the dyes are virtually intact impermeable covered stainings. Are quite frequent incomplete particles formed by capsid devoid cores. The genome of varicella virus has been completely decoded, consisting of 73 genes encoding proteins equal number; its size is 130-230 kbp The life cycle of varicella virus is similar to all virus and consists of the following phases: Input: virus entry into the host cell involves a specific interaction of the virus with the receptors expressed on the surface of the plasma membrane of the cell. Although not exactly known the exact mechanism of virus binding to these receptors, it is known that several envelope glycoproteins of the virion that interact with receptors of the cell membrane; They have identified several cellular receptors, called gE, gB, gH, gI, gC, gL and all with glycoprotein structure.
Once the virus attached to these receptors rapidly produce a fusion process between the viral particle and plasma membrane. In a micro-areas of the cytoplasm called “rafts” or “rafts” (rafts) of lipidic nature anchoring viral glycoproteins or glycoprotein receptor occurs. The fusion allows capsid is integrated into the cell cytoplasm, releasing the viral DNA which is able to penetrate the cell nucleus through micropores Replication: The varicella virus is a virus whose replication is semi-conservative (belongs to the class I virus as classified by Baltimore). Using the enzymatic machinery of the cell, the viral DNA is replicated, exported to cytoplasm ribonucleínicos complexes resulting from the binding of the products of replication to a core protein. Assembly: the assembly of viral components takes place through a process called “budding” (shoot formation). Rafts or almadías described above also play an important role in this phase of the cycle as they would have a great affinity for the protein and molecules which result glycoprotein synthesis induced in the Golgi complex by viral ribonucleínicos. In these rafts the various components of the capsid protein and the cover would join creating a bulge in the cell membrane Release: As are integrated components virion outbreaks are taking an increasingly spherical shape until, when it has completed the assembly of the parts, the virus particle is clear from the cell by a process similar to the exocytosis
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Anabel Cristina de la Torre – Pediatrician As we discussed in the previous topic, herpes zoster (or shingles) is produced by the virus that causes chickenpox. After suffering from chickenpox, the virus remains in nerve ganglia quartered and when reactivated herpes zoster results. Why is reactivated? by lowering of defenses or to unknown causes. It appears at any age but is more common in adults than in children. It can appear in different locations (otic herpes, ophthalmic, thoracic, abdominal . . . ). In childhood is more common contagious torácico. ¿Es? Shingles is not spread but the virus itself.
If a person with herpes zoster infects another who has never had contact with this virus, the picture that produces it is chickenpox. The virus is transmitted when the lesion is blistered by direct contact with them. Before the blisters appear not spread and when the scabs appear either. What are the symptoms? – Pain though usually in children is rare. It is more typical in adults. – Surface stinging or tingling in the area even before it leaves the injury. – Very rarely a fever or malaise. – The nearby lymph-injury can become inflamed. – First comes a red area on the skin, hours on that area granites appear close together that then turn into blisters and then crust over them out. The evolution is favorable in children without complications or scarring. Recovery is complete within 2-3 weeks. Pain after the lesion has disappeared does not usually occur in children if there may take weeks to disappear.
How is it diagnosed? Like chickenpox, watching lesión. Tratamiento In children usually heals without treatment. Your pediatrician seeing the injury decide whether to put another treatment or not. It can be applied in solutions herpes copper or zinc sulfate 1/1000 to avoid sobreinfección. Prevención Keep covered injury. Avoid touching or scratching. Wash hands frequently. Until scabs forming avoid contact with Pregnant women who have not had chickenpox or have been vaccinated people with low defenses
Day 11/28/2013 – 5:05 p. m. What is it? It is a skin infection caused by a microorganism called varicella-zoster virus (VZV). The virus is so named because it is the responsible agent of both varicella zoster and herpes. Usually the first contact with the VZV we have in childhood and is clinically manifested as chickenpox. After this infection, the virus migrates by nerve endings from the skin to the ganglion and there is latent, reappearing on the skin in certain situations giving rise to the called herpes zoster. Who can get it? It occurs mainly in adults, but is increasingly common in children appeared. To suffer it is necessary to have previously been in contact with the virus and have had chickenpox. The incidence of this disease and its severity are greater in individuals who are immunosuppressed, either by treatment with chemotherapy or radiotherapy or immunosuppressive drugs such as transplant patients. Also included in this group of patients with AIDS and those with tumors or other diseases that determine a situation of immunosuppression. However, it is also common to observe herpes zoster in immunocompetent persons in situations of weakness or fatigue.
What are your symptoms? The patient notices an itching sensation or pain in skin territory (preferably the trunk) and 4 to 5 days after presents a reddening of the skin in that area on sprouting vesicles which are arranged grouped. During this phase the lesions are highly contagious as the virus is inside the vesicles. After 7 to 10 days the lesions are dried, forming a yellowish brown crusts removed, sometimes leaving a residual scar. The areas most frequently affected are the trunk, thigh or ocular region. The latter presents a more serious as there is the risk of formation of corneal ulcers leading to the ceguera. En occasions, after the episode of herpes zoster residual pain may persist at that location that remains for days, months and even years, denominating neuralgia herpetic. This happens most often in individuals whose age exceeds 50 years. How is it diagnosed? The diagnosis is mainly based on clinical symptoms. In doubtful cases it can be confirmed by performing virological crop of vesicles in the initial phase of the disease. Which is the treatment? The treatment of herpes zoster is done with antiviral drugs orally or intravenously, but it is not always necessary to treat it as it resolves spontaneously in about 7 days.
The treatment is indicated mainly in immunosuppressed patients, the risk of spreading the virus to other organs. In these patients the use of intravenous treatment is necessary. It is also indicated treatment with antiviral drugs orally in patients over 50 years to reduce the chance of developing post-herpetic neuralgia (brivudine, acyclovir, valacyclovir, famciclovir). It is important to note that the treatment is effective if started within 72 hours from the start of the vesicles and to be avoided superinfection of lesions using topical antiseptics. PHN, if present, can be treated by analgesics and, if not improve, other drugs such as anticonvulsants or antidepressants may be used. What is the prognosis? Shingles is usually self-limiting that resolves spontaneously within one or two weeks. In some patients herpetic neuralgia may persist variable duration. In immunocompromised patients there is a risk of spread of the virus with involvement of other organs and worse prognosis. Hence the importance of early diagnosis and treatment in these patients. With regard to location, ocular herpes has a worse prognosis for the rest, the possibility of evolving ceguera. Es important comment that herpes zoster is a contagious disease and during its duration contact with people should be avoided not they have been in contact with the virus previously, especially if they are immunosuppressed or pregnant women.
What is Zostavax? The Zostavax is the vaccine used in adults 60 years or older to prevent herpes zoster (shingles). The zostavax works by helping the patient’s immune system to protect against shingles and herpes pain and other serious complications that can occur. If a herpes zoster develops, even having been vaccinated, the zostavax can help prevent nerve pain that occurs during and after infection Why do I get vaccinated with Zostavax interested? If children have suffered from chickenpox, it is very possible that the virus that caused it are stored dormant in my lymph nodes. From age 60, as my immune resistance decreases, these viruses can reactivate causing her disease called shingles. The Zostavax vaccine prevents this revival have and protect me from disease and, above all, the pain that this disease causes (called herpetic neuralgia post) How do I know if I get vaccinated with Zostavax? If you are over 60 years and has suffered from chickenpox small and if you have allergy problems or other illnesses, you should be vaccinated with Zostavax to prevent her chance of getting the disease. If there is a possibility of contact with sick chicken pox or herpes zoster, it is even more important to protect against possible infection Does it protect me completely Zostavax against infection by the herpes zoster virus? No.
But in more than 38,500 men and women over 60 years who were vaccinated with Zostavax, the incidence of disease in vaccinated patients was 53. 5% lower than in patients treated with placebo. Moreover, in the unlikely event of becoming infected with the virus, Zostavax reduced by 66. 5% the incidence of post herpetic neuralgia and 61. 5% the pain and discomfort caused by it When I can not get vaccinated with Zostavax? The Zostavax vaccine contains, besides the attenuated herpes zoster virus, neomycin and gelatin. Therefore, in cases of allergy or hypersensitivity to these components, should not be vaccinated with Zostamax. In addition, the Zostavax is contraindicated in patients suffering from primary or acquired disease inmudeficiencia (eg leukemia, lymphoma or AIDS). Although attenuated vaccine viruses are alive and in immunocompromised patients, can cause disseminated disease What are the adverse effects of Zostavax? The most common adverse reactions are those produced locally at the injection site, such as pain or redness. They are usually mild or moderate and disappear within a few days.
Fever only occurs in 1. 7% of cases Zostavax interactions Zostavax No known interactions with other medicines or vaccines. Have been administered simultaneously (but at different sites) Zostavax vaccine and flu without problems patients 50 or more years Why not protect me herpes zoster varicella vaccine if both diseases are caused by the same virus? It is because, although the virus is the same from morphologically, antigenically vaccines are different, in the sense that the immunity provided by the vaccine ZOSTAVAX is much more powerful than that provided by the varicella vaccine. This difference is due to the greater number of attenuated viruses (19,500 colony forming units) in a dose of vaccine compared to zostavax 1350 colony forming units in a dose of varicella vaccine How to manage the Zostavax? The zoster vaccine should be administered as a single dose of 0. 65 mL in the deltoid region of the upper limb
Herpes zoster Concept: infectious, viral, acute skin disease, localized, which causes usually eritematovesiculosa painful rash. Etiology: varicella-zoster, member of the Herpesvirus family of DNA viruses, one serotype. pathophysiology: • It is a recurrence of chickenpox. • After recovery, the virus remains latent in the ganglion cells of the spine, in lethargic in nerve tracts that emerge from the spinal cord. It is asymptomatic and inactive. • After the year is reactivated and spreads along the nerve tract. Clinical picture: • It is accompanied and / or preceded by nerve pain, numbness, burning, burning sensation. • eritematovesiculosas lesions in small bouquets, in areas where spaces are separated by healthy skin, following peripheral nerve skin territory. Therefore they are unilateral, without exceeding the midline. clinical forms: Ophthalmic, middle branch of the trigeminal (maxilla) lower branch of the trigeminal (mandibular), Cervical, brachial, intercostal, Lumbo femoral, sciatic Sacro, geniculate ganglion.
Differential diagnosis: Herpes simplex, acute contact dermatitis, Varicella Date: 08/05/10 Owner: Virtual University of Health 17 items Hepers brachial Zoster, woman 44 years Date: 07/12/10 Owner: Virtual University of Health Views: 2875 Hepers Zoster, woman 44 years Date: 07/12/10 Owner: Virtual University of Health Views: 1240 Herpes Zoster Instercostal, woman 61 years
Date: 05/18/10 Owner: Virtual University of Health Views: 1728 Herpes Zoster Instercostal, woman 61 years Date: 05/18/10 Owner: Virtual University of Health Views: 1562 Herpes Zoster Intracoastal right side Date: 03/19/08 Owner: Virtual University of Health Views: 5373 Herpes Zoster Intracoastal woman 60 years Date: 05/03/10
Owner: Virtual University of Health Views: 2004 Herpes Zoster Intracoastal, erythema, vesicles and scabs, man 20 years vesiculoso erythematous syndrome Date: 04/05/10 Owner: Virtual University of Health Views: 5365 Herpes Zoster Intracoastal, woman 60 years vesiculoso erythematous syndrome Date: 05/03/10 Owner: Virtual University of Health Views: 2865 Herpes Zoster Intracoastal, woman 60 years
Date: 05/03/10 Owner: Virtual University of Health Views: 2029
Chicken pox used to be one of the necessary transitions of childhood. Since the appearance of the vaccine against varicella-zoster virus (VZV), most children can now prevent this infection. But it is possible that the person who has had chickenpox can get shingles; even if that person is a child. Luckily, shingles is not very common in children and adolescents with healthy immune systems. Basic description of shingles Shingles, also called “shingles” is a skin rash caused by a viral infection of the nerves that lie just under the skin. Shingles usually appears as a band of irritated skin with blisters on one side of the chest or back, but may also appear elsewhere in the body, like the face and around the eyes. Many cases of herpes zoster have mild symptoms, but severe cases can be very painful. Fortunately, both children and adolescents usually have mild cases; severe cases affect only older people. Shingles is caused by the same virus that causes chickenpox and, therefore, is highly contagious. This means it is very easy for a child pass the virus to others who are not immune to chickenpox. This includes all those who have not had chickenpox or have not received the vaccine. However, infected with the virus, they will not develop shingles but they become infected with chickenpox.
An episode of shingles usually heals itself and disappears in less than a month. While an outbreak of shingles goes away, there are treatments that can reduce the risk of complications and help your child heal faster. Causes Both shingles and chickenpox are caused by the varicella-zoster virus. This virus is related to the herpes virus that causes cold sores and genital herpes. For this reason, the condition is called herpes zoster. Once a person gets chickenpox, the virus remains in the nervous system of the person the rest of his life, even cure chickenpox. The virus remains dormant, or inactive for years. In many people, never reappears. But in about 1 million Americans a year, the virus reappears and causes shingles. You may get shingles more than once, although it is rare. Doctors do not know for sure why outbreaks of herpes zoster after months and years of inactivity are generated. May be due to age, our immune system is weakened becoming more vulnerable to infections.
This would explain why shingles is more common in older people. Children who have had chickenpox have a higher risk of getting shingles if their immune systems are weakened because of a disease such as AIDS or cancer or taking certain medications.
09 March 2010By hola. com Last Review: 2010-03-09 by Dr. Alfonso Jose Santiago Marí What is Shingles? Shingles is a painful rash caused vesiculosa by the varicella-zoster virus (Herpes varicellae), which is the same virus that causes chickenpox, especially in children under 10 years. However Shingles occurs most often in people between 50-80 years of age. It occurs in people who have had chickenpox and is a reactivation of the virus asleep. Shingles is contagious by direct contact and can trigger chickenpox in a susceptible person. However, contact with a person with shingles can not be contagious. What causes shingles? After contracted chickenpox virus, it travels along the nerves of the skin to the nerve roots, where it becomes dormant. The virus remains seated in the nerve ganglia throughout life.
As a result of re-infection or due to reactivation of latent virus, a state of immune deficiency, damage would occur and so that the disease affects a nerve in a localized segment is explained. Generally Shingles affects older people, but occasionally occurs in children who have had chickenpox during their first year of life and in people with immune deficiency, such as those caused by HIV or certain drug treatments. Of interest We suggest reading the following articles: Viruses and bacteria Chickenpox Fifth Disease herpes simplex What are the symptoms? Shingles is a disease that affects a nerve segment (part of the body innervated by the same nerve). The first symptom due to the reactivation of the chickenpox virus is a burning sensation in the nerve pathways, accompanied sometimes by a slight increase in temperature and generalized fatigue. an oval erythema, ie a reddening of the skin that follows the path of a nerve segment and a pain intensity can be increased progressively later appears. Then there is a rash, consisting of one or more groups of vesicles of liquid content becomes more yellowish and opaque.
The pain and subsequent rash correspond to the position of nerve pathways and almost always are only one side of the body or face. Normally, the eruption reaches its peak after three to five days. Then, the blisters (large blisters) begin to dry, broken and covered in a brownish crust. The scabs fall off after two to three weeks and may leave scars. The pain suffered by the patient may seem disproportionate considering the extent and severity of the rash. In some people, after the scabs have disappeared, pain can persist from a few weeks to several months. This highly unpleasant after-effect of shingles is called postherpetic neuralgia. How can it be prevented? Those who have never had chickenpox can reduce the risk of contracting the virus by avoiding contact with people with chickenpox and shingles. You may receive an Zoster in an adult who has been in contact with a child with chickenpox or another adult with shingles. However, most patients develop Shingles without knowing what the cause of his illness. How is it diagnosed? Usually the patient history and physical examination is usually sufficient for diagnosis.
If necessary, a scraping of the blisters can help identify the virus. A blood test may also be useful to confirm the initial diagnosis. What are the complications? The rash can become infected by bacteria An outbreak of herpes zoster in the vicinity of the eyes can cause corneal scarring, affecting vision. Shingles on the face can, in some cases, lead to a temporary loss of hearing, facial paralysis and a decreased sense of taste. The Zoster in the head can produce meningeal symptoms with stiff neck and headache. Forecast Shingles is rarely serious. In about 90% of patients, the attack usually subside in less than a month after the onset of symptoms. Most people suffer only one or two attacks on his life. Older people, especially, may continue to feel pain, even after other symptoms disappear. What measures can be taken at home?
Try not to scratch it. Use soothing lotion to relieve irritation. Wet applications with zinc or copper sulfate is used to dry the lesions and prevent superinfection. Use simple analgesics such as aspirin or acetaminophen to relieve pain. When should you see a doctor? When any of the following circumstances: The rash around the eyes or the top of the nose. The injuries do not heal after 10 days. The patient has a high fever, headache or see any of the above described complications. The patient has another serious illness at the same time. Patients for whom infection poses a high risk, such as pregnant women and immunocompromised patients. What treatment should be used? Treatment is symptomatic, mainly analgesic and antiviral.
In certain cases they can be used antiviral drugs such as acyclovir, valacyclovir or famciclovir, most useful as soon as possible are used. If the rash is present for more than 48 hours, the value of this treatment will be reduced. The drug can reduce the duration of the attack and prevent its spread. This treatment probably reduces the duration of PHN. The doctor may also have to deal with additional complications, such as a bacterial infection. If simple analgesics are not effective, your doctor may prescribe other drugs to relieve pain and associated usually given vitamin complexes, with vitamin B. In older patients with oral corticosteroid treatment appears to decrease the incidence of post-herpetic neuralgia. Dr. Flemming Andersen, specialist in dermatology; Dr. Dan Rutherford, GP
If you ever had chickenpox surely you remember that feeling of itching. The good news is that never suffer from chickenpox. The bad news is that if you had chickenpox, you may someday have a rash called “shingles” (shingles). Luckily, shingles is not very common in children and adolescents with healthy immune systems. But if you’ve heard of this disease, or know someone who has suffered, surely you wonder what it is. What is shingles? Shingles is a skin rash caused by a viral infection of the nerves that lie just under the skin. The virus that causes shingles is the same one that causes chickenpox. Most teenagers contract a slight herpes zoster, but this rash is painful when the virus attacks a person. Shingles usually appears as a band of irritated skin with blisters on one side of the chest or back. It can be located anywhere in the body, even in the face near the eyes. Since the virus that causes shingles is the same that causes chickenpox is highly contagious. It is very easy to pass the virus to another person who is not immune to chickenpox (such as people who have not yet had chickenpox or the vaccine never gave varicella).
The difference is that, to be infected with the virus will not develop shingles. Instead, they become infected with chickenpox. Shingles usually disappears within a month. While an attack of shingles goes away, there are treatments that reduce the risk of complications and help people heal faster. What causes shingles? Both shingles and chickenpox are caused by the varicella-zoster virus. This virus is related to the herpes virus that causes cold sores and genital herpes. For this reason, the condition is called herpes zoster. Once a person gets chickenpox, the virus remains in the nervous system of the person the rest of his life and remains dormant, or inactive for years. In many people, never reappears. In other people, the virus reappear and cause shingles. Certain people suffer outbreaks of shingles more than once; although this is not very common. Doctors do not know for sure why outbreaks of herpes zoster after months and years of inactivity are generated.
You may be because the immune system becomes more vulnerable as people age. This may be the reason why shingles is most common in adults and in people whose immune system is weakened because of a disease like AIDS or cancer. People who receive treatment for cancer or taking medications that may weaken the immune system are also more likely to get shingles. What are the symptoms of shingles? In many cases, the first thing you notice is a tingling, pain, or itching in the area where the rash appears. This may happen a few days before the onset of the rash, which means that the person with shingles feel itching, tingling, or pain and have no idea why. Appearing The rash looks like a group of grains or beans stripes on one side of the body or face. Grains turn into pus-filled blisters that open and form scabs in about 7 to 10 days. When the blisters have scabs it means they begin to heal. Scabs heal and fall in about two to four weeks after the rash appears. Some people with herpes zoster develop fever, headache, fatigue, and general body aches. In very rare cases, it is possible that the person suffering from shingles have pain without rash. Some people (usually elderly) suffer severe symptoms.
complications Most cases of shingles heal themselves and do not trigger other problems. In very rare cases, shingles can lead to complications such as: continuous pain. The damaged nerve fibers in the skin can send wrong messages to the brain, causing pain that can remain for extended periods, even after shingles has disappeared. Doctors call this situation “PHN”. Eye problems. If the person has shingles near the eye, or directly in the eye, it can cause loss of sight. More skin infections. The rash of shingles can become infected with bacteria and trigger other infections such as impetigo or cellulitis. Problems in the nervous system. You may face shingles involving nerves that connect to the brain. This can cause facial paralysis, hearing or balance problems in some people.
In rare cases, shingles can cause encephalitis (brain inflammation). What should you do? If you think you have shingles, call a doctor. If you think you have facial herpes zoster, contact a doctor immediately to prevent the infection from spreading to the eyes. People with weakened immune systems should receive medical attention immediately to avoid complications. Usually the doctor can diagnose shingles examining the rash and blisters patient. In rare cases, doctors may take a sample of the infected for analysis in a laboratory tissue. Which is the treatment? You can administer antiviral drugs for the episode of shingles heal faster and the chances of having complications are reduced. However, not all patients have to take antiviral drugs. Your doctor will prescribe the if deemed necessary. If you need to take them, the sooner you take more effective they will be. Antiviral drugs can not eliminate the virus from the body, which means they can not prevent you have more outbreaks in the future.
To relieve the pain associated with shingles, doctors or nurses typically prescribe a cream, an aerosol or a patch to numb the skin. There are also prescription and nonprescription pain reliever. Do not take aspirin. Aspirin exposes adolescents to a greater risk of a rare but serious disease called “Reye syndrome. ” If you suffer from herpes zoster that gives you itch, maybe your doctor may recommend creams or medicines called “antihistamines”. Keep the rash area clean by washing with water and mild soap. Place cold, wet compresses to the blisters several times a day to relieve pain and itching. The baths with oatmeal usually give relief. Is it possible to prevent shingles? There is no way to completely prevent shingles. The varicella vaccine can cause shingles is less serious. Therefore, if you have not had chickenpox, ask the doctor to give you the vaccine.
A vaccine against shingles, but doctors only managed to older adults. This is because the higher it is, the more severe shingles. It is very unlikely that a teen shingles is severe. If you get shingles, you can prevent the virus from spreading by keeping the affected area with the rash covered at all times and following a treatment, if needed area. People suffering from shingles should stay away from newborn babies, pregnant women and anyone whose immune system is weakened, or anyone who is not immune to chickenpox, until the rash is gone. Therefore, those affected adolescents shingles should stay home for a while. It all depends on the person and situation. Your doctor will advise you. Shingles can be scary, but this is due to the way it affects adults. The good news is that the infection usually does not affect adolescents. And even if it affects the adolescent, usually it is not serious.
MYTH: Shingles develops when an adult of a certain age are infected by the varicella virus FACT: Shingles is caused by reactivation of a dormant varicella virus present in the body from an episode of chickenpox. Once this condition is resolved, the virus remains dormant in nerve cells near the spine. Age and other factors that alter immunity increase the risk that the virus is activated causing Shingles MYTH: herpes zoster (shingles) is not contagious FACT: A healthy person contact with a person with herpes zoster does not cause shingles to another person. However, a person with shingles can transmit the virus to a person who is not immunized against chickenpox virus MYTH: The first sign of shingles is a rash with fluid-filled blisters FACT: The first sign of shingles is a feeling of burning pain or paresthesia located on one side. This prodrome can last from 1 day to 3 weeks before the typical macular rash emerges; this evolves then the characteristic vesicular rash of shingles, shingles. Shingles usually manifests unilaterally, chest or trunk or along the face or scalp MYTH: the discomfort of shingles last until the rash disappears FACT: You can remain intense pain until 30 days after the rash or blisters have healed and disappeared.
This is an important complication of shingles and is called post-herpetic neuralgia MYTH: antiviral drugs should be administered before the rash is revealed to be effective FACT: administered as soon as the greater antiviral drugs (acyclovir, valacyclovir or famicyclovir) is the probability of thwarting an outbreak. However, these drugs can reduce the severity and duration of symptoms of an outbreak has occurred even when the rash, especially if administered within 72 hours. Antiviral treatment also reduces post-herpetic pain
I primi sintomi dell’herpes zoster I sintomi iniziali mal di testa possono includere, sensibilità alla luce, sintomi semi-influenzali (cioè senza febbre), pruritus, formicolio, eruzione di zone with skin rash. Sintomi and segni di herpes zoster In molti almost, i primi segni and sintomi dell’herpes zoster if verificano premium due or tre giorni della dell’inizio caratteristica cutanea eruzione. Questi sintomi iniziali includere possono brividi, ingrossamento dei linfonodi ed one Bruciante dolore. L’eruzione herpes zoster if sotto manifest form vescicole piene diverse piccole di liquid (simile alla varicella). In alcuni almost, i sintomi herpes zoster può complicanze portare to eat cecità temporanea or permanent. A seconda dei nervi coinvolti il herpes zoster virus parti può Colpire molte corpo. Sintomi and segni zoster virus herpes sono legati spesso to: estrema sensibilità or dolore in a long fascia its a lato di corpo with a sensazione pruritus, formicolio, bruciore , Costante dolore. Sintomi altri che non specifici nello stesso tempo possono verificarsi sono: febbre, mal di testa and brividi. 1-3 giorni dopo dopo Generally the virus formazione if I avvertono dolore ed eruzioni cutanée convescicole, diventano piene di che poi pus and formano delle croste. In alcuni almost, if only può avvertire senza dolore l’cutanea eruzione or delle bolle. Solitamente ilrash perché scompare cutaneo croste him if staccano 2-3 settimane dopo, ma possono lasciare delle cicatrici.
Le complicazioni sono di herpes zoster: ben il 15% delle persone affette gives herpes zoster postherpetic sviluppano the nevralgia and the maggior parte di questi almost if you check in with più di 50 persone anni di persone che nelle ETAE hanno un indebolito immunitario di un’altra system because malattia, come il infezione da l’diabete or HIV. Può verificarsi one estensione di zoster virus disseminata much of its corpo e può il cuore Colpire, polmoni, fegato, pancreas, articolazioni, and tratto intestinale. L’infezione può diffondersi ai nervi and man cause debolezza temporanea. Complicazioni to cranico nervo che possono includere: infiammazione, and Perdita di dolore sensibilità in one or entrambi gli occhi, intense all’orecchio dolore, a skin eruzione intorno all’orecchio, bocca, viso, collo and Capelluto cuoio and Perdita di movimento nei nervi facciali (sindrome di RamsayHunt). Altri sintomi possono includere the dell’udito perdita, Vertigini and ronzio alle orecchie, perdita taste and asciutta della bocca gli occhi e anche possono verificarsi. Cicatrici and scolorimento della pelle. Infezione batterica delle vesciche. The muscolare debolezza nella zona della pelle infetta premium, during or dopo shingles. Herpes zoster sintomi dolorosi Sintomi dolorosi verificarsi possono in caso di eruzione gonfiore cutanea e che tende to verificarsi its a lato del corpo eats a precoce sintomo (solitamente its sheen and petto). Ci può essere dolore, intorpidimento or formicolio area nella 04. 02 per premium and potrebbe giorni anche più a lungo persistere dopo l’stessa eruzione.
Una delle più comuni complicanze rappresentata da dolore è quasi spesso intollerabile compare anche che dopo un mese dalla guarigione delle vescicole cutanée or può ripresentarsi, eats questo caso di comes classificato post-erpetica nevralgia. Tale dolore per molto tempo può persistere e non è chiaro perché possa verificare tale dolore if only in alcune persone. Herpes Zoster ed i farmaci antidolorifici Per il dolore alleviare causato gives di herpes zoster virus, medical potrebbe il che prescrivere dei farmaci possono contenere: Paracetamolo: antidolorifico comunemente l’il più è usato paracetamolo, senza che è disponibile medical prescrizione. In ogni case if you istruzioni consiglia dileggere per semper che sia adatto drug assicurarsi il che alla situazione if assumi the corretta dose. Anti-infiammatori non steroidei (i cosiddetti FANS): ad esempio in questa category troviamo l’ibuprofen, alternative medicine antidolorifico eat. Tuttavia, questi sono da non farmaci assumere in caso di: problemi di stomaco, Reni or fegato, asthma, stato di gravidanza or Allattamento. Comunque è semper il meglio consultare doctor per assicurarsi di poter assumere farmaci tali. Oppioidi: sono dal prescritti doctor in case di dolori piuttosto evidenti negli adulti (ad esempio codeine). Questo è un più forte di un type antidolorifico che essere potrebbe I prescritto assieme to paracetamolo. Antidepressivi: is if you have dolore di un forte because di herpes zoster, anche il prescrivere medical potrebbe one antidepressivo drug, che essere utile potrebbe the causato dolore nella gestione da shingles. Possono particolarmente essere utili in case prolungato di dolore.
Anticonvulsivanti: sono per il controllo spesso utilizzati delle convulsioni (or attacchi) causate da epilessia, ma Tuttavia, possono aiutare anche il dolore gestire neuropathic. Lavorano stabilizzando elettrica l’attività dei nervi all’interno the vostro cervello. Gabapentin Ad esempio il più è il anticonvulsant drug comunemente prescritto per il dolore drifter dall’herpes zoster. Herpes Zoster ed i farmaci antivirali Oltre a farmaci antidolorifici, alle persone da herpes zoster virus colpite può essere anche prescritto one antivirale che porta ai seguenti drug benefici: ridurre the fuoco di Sant’Antonio gravità of, is if it catches in particolare nelle prime Fasi della malattia ridurre the dell’herpes durata zoster prevenire you complicanze di sviluppo, eating postherpetic nevralgia I farmaci antivirali quando sono più efficaci vengono assunti entered dell’eruzione 72 ore dall’inizio cutanea. Esempi difarmaci antivirali solitamente che per il trattamento if prescrivono di Herpes Zoster sono: Zovirax Valtrex Famvir
Herpes Zoster and HIV sintomi Herpes zoster virus Il colpisce in generating and maggiormente you persone dai 50 anni in your e soprattutto quelle persone sono i cui immunitari sistemi per l’infezione indeboliti stati da HIV, canker per il trattamento oppure il with immunosoppressori farmaci. Generalizzata persistent lymphadenopathy spesso è il primo di sintomo primary infezione gives HIV, eat anche: lesioni the cavo orale come il mughetto and the pelosa orale leucoplachia, Disturbi ematologici quali l’anemia and thrombocytopenia, Disturbi neurologici eat asettica meningite, and Disturbi dermatologici eat varicella (fuoco di Sant’Antonio). Herpes zoster infection The trasmissione di questo virus mainly avviene attraverso il contatto diretto or indiretto with fluid and rarely il delle vesciche può essere nelle trasmesso goccioline di Saliva dal naso e dalla bocca. In evitare ogni case è il contatto consigliabile ravvicinato with persone che da fine risultano affette herpes zoster virus to the guarigione dell’eruzione dopo delle vescicole. E ‘particolarmente important evitare il contatto con le persone shingles affette da da: persone che sono di rischio particolarmente to varicella or shingles donne incinte neonati e bambini chi non ha mai avuto varicella chiunque sia malate Tutte quelle persone che hanno il debole immunitario system (chi has HIV or diabete).
Herpes zoster eat if cure Esiste one vaccino per la protezione contro il zoster virus dell’herpes tutt’oggi ma sono in corso studi per il vaccino verificare is aiutare può to prevenire lo sviluppo e ridurre the dell’herpes gravità zoster. Nel caso di semplice localizzata herpes zoster, il trattamento consists mainly nell’utilizzo locali e di di antisettici antibiotic per via orale l’secondaria infezione is appare. In case anche di dolori solitamente if I prescrivono analgesici dell’acido derivati salicilico and paracetamolo, altrimenti se non sono sufficienti if I prescrivono antidolorifici più potenti the benzodiazepine. Le cure herpes zoster per tutta aiutano ad alleviare the drifting symptoms. Nel case if sviluppi in cui il l’trattare bisogna skin rash and cutaneous eruzione: mantenere l’eruzione cutanea asciutta pulita e per il ridurre rischio eruzione infezione da di batteri indossare Indumenti Larghi, comodi and soprattutto di naturale fiber meglio evitare di usare rallentano Cerotti in quanto il processo di guarigione. It utilizzare one medicazione non avete bisogno di aderente is coprire Le Bolle, per esempio per prevenire the ad altri trasmissione the virus. I will use a cream or lozione with effetto per il alleviare soothing itching. Può anche essere a utile per prevenire antihistamine itching during notte. Herpes Zoster cure and RIMEDI naturali
Le cure naturali per il trattamento of herpes zoster virus sono semper più persone note in quanto le cure provano tali per evitare i tradizionali farmaci sapendo ma che vengono sfruttate you proprietà che sono delle Erbe anti-Virali and antimicotiche. Alcune delle Erbe dell’herpes che nel trattamento vengono utilizzate elencati sono di seguito: Echinacea: combinata with Andrographispaniculata, è unpotente antivirale, negation, the modality che i tessuti infetti ripristinare per la pelle ed threes aiuta to ridurre l’infiammazione causata dal virus. Olive (Olea europaea): le foglie in particolare has antivirali proprietà che contro il agiscono dell’herpes virus and, threes, induces virale diffusione and arrest the virale riproduzione. Erba di S. Giovanni (Hypericum perforatum): iperico Notissimo antivirali proprietà che il has aiutano to combattere infezioni gives you herpes. Korean ginseng (Panax ginseng): estratto di Korean ginseng contains Anticorpi che il corpo aiutano to combattere infezioni gives you herpes. Siberian Ginseng (Eleutherococcussenticosus): è efficace delle lesioni nel trattamento da herpes genitale. Melissa (Melissa officinalis): Melissa contains polifenoli aiutano che nella dell’herpes cure virus. Liquirizia (Glycyrrhiza glabra): è l’efficace nel controllare infezione gives herpes virus. Astragalo (Astragalusmembranaceus): contains polisaccaridi aiutano che il rafforzare immunitario and pertanto system combattere contro il dell’herpes virus. Goldenseal (Hydrastiscanadensis): è usato per trattare i sintomi di herpes oculare. Sambuco (Sambucuscanadensis): che grazie ai suoi flavonoidi aiuta ad aumentare il immunitario system.
Aglio (Allium sativum) has ottime proprietà anti-Virali. Prima di tutte le proprietà utilizzare delle Erbe sovraelencate if one possa consultare consiglia di che l’effettiva medical valutare herpes zoster virus serietà per poi procedere alla migliore cure the case. Riassumendo: Quanto l’hard herpes zoster? L’infezione hard virale in genere da 2-4 settimane, ma i dolori permanere possono molto più per tempo, per settimane or mesi addirittura. Nel case if Manifesti, alcuni sono efficaci RIMEDI naturali per rinforzare you difese lenire immunitarie e il dolore: Per lenire sono i Disturbi efficaci tisane di erbe, olio e particolari di iperico RIMEDI omeopatici. Suggerimenti in Presenza di herpes zoster: L’herpes può essere contagious contratto per chi non ancora chickenpox. È quindi consigliabile lontani da questi ultimi rimanere per almeno 2 settimane. Threes, nuovi per evitare che nelle germi if insedino vescicole, non wash the area Colpita finché will bollicine inizieranno to seccarsi. Sintomi cause and cure semplici RIMEDI naturali contro l’herpes zoster. benessere naturale
Chicken pox used to be one of the necessary transitions of childhood. Since the appearance of the vaccine against varicella-zoster virus (VZV), most children can now prevent this infection. But it is possible that the person who has had chickenpox can get shingles; even if that person is a child. Luckily, shingles is not very common in children and adolescents with healthy immune systems. Basic description of shingles Shingles, also called “shingles” is a skin rash caused by a viral infection of the nerves that lie just under the skin. Shingles usually appears as a band of irritated skin with blisters on one side of the chest or back, but may also appear elsewhere in the body, like the face and around the eyes. Many cases of herpes zoster have mild symptoms, but severe cases can be very painful. Fortunately, both children and adolescents usually have mild cases; severe cases affect only older people. Shingles is caused by the same virus that causes chickenpox and, therefore, is highly contagious. This means it is very easy for a child pass the virus to others who are not immune to chickenpox. This includes all those who have not had chickenpox or have not received the vaccine. However, infected with the virus, they will not develop shingles but they become infected with chickenpox.
An episode of shingles usually heals itself and disappears in less than a month. While an outbreak of shingles goes away, there are treatments that can reduce the risk of complications and help your child heal faster. Causes Both shingles and chickenpox are caused by the varicella-zoster virus. This virus is related to the herpes virus that causes cold sores and genital herpes. For this reason, the condition is called herpes zoster. Once a person gets chickenpox, the virus remains in the nervous system of the person the rest of his life, even cure chickenpox. The virus remains dormant, or inactive for years. In many people, never reappears. But in about 1 million Americans a year, the virus reappears and causes shingles. You may get shingles more than once, although it is rare. Doctors do not know for sure why outbreaks of herpes zoster after months and years of inactivity are generated. May be due to age, our immune system is weakened becoming more vulnerable to infections.
This would explain why shingles is more common in older people. Children who have had chickenpox have a higher risk of getting shingles if their immune systems are weakened because of a disease such as AIDS or cancer or taking certain medications. symptoms In many cases, the first thing you notice is a tingling, itching, and sometimes pain in the area where the rash appears. This can be frustrating: The child will feel itchy, but you will have no idea what is causing it. When the rash appears finally begins as a cluster of grains on one side of the body or face. Grains turn into pus-filled blisters that open and form scabs in about 7 to 10 days. When the blisters form scabs it means they begin to heal. Scabs heal and fall about 2 to 4 weeks after the rash appears. Some children with herpes zoster develop fever, headache, fatigue, and general body aches. In very rare cases, it is possible that the child suffering from shingles have pain without rash. Some people have more severe symptoms, but usually this occurs in people over 50 years. complications
Most cases of shingles heal themselves, with or without treatment, and do not trigger other problems. In very rare cases, shingles can lead to complications such as: Continuing pain (PHN): Damage to nerve fibers in the skin send wrong messages to the brain, causing pain that may remain for long periods after the shingles has disappeared. Vision problems: If shingles appears near the eye or directly in the eye, can cause loss of sight. Skin infections: The rash of shingles can become infected with bacteria and cause impetigo or cellulitis. Nervous system problems: You may face herpes zoster may involve nerves that connect to the brain. This can cause nerve problems like facial paralysis, hearing or balance. In rare cases, shingles can cause encephalitis (brain inflammation). Diagnosis If you think your child has shingles, call a doctor. If you think your child has shingles on the face, it is vitally important that you consult a doctor immediately to prevent the infection from spreading to the eyes. If your child has a weakened immune system, call your doctor immediately to avoid complications. Usually the doctor can diagnose shingles simply by examining the rash and blisters of the child.
In rare cases, the doctor may take a sample of the infected for analysis in a laboratory tissue. Treatment Not all children who suffer from shingles require treatment. If the doctor decides that a treatment might help you improve, this should be done as soon as possible. Antiviral drugs can not eliminate the virus from the body but can reduce complications and help speed recovery. The sooner treatment begins, the more effective and run less risk of complications. Talk to a doctor about whether it is advisable that your child take medicine. To relieve the pain associated with shingles, doctors often prescribe a cream, an aerosol or a patch to numb the skin and reduce pain. There are also prescription and nonprescription pain reliever. Do not give your child aspirin because it can cause a rare but serious illness called “Reye syndrome. ” If shingles is accompanied by itching, your doctor may recommend medications or lotions with medicines called “antihistamines”. To help relieve symptoms at home, keep the affected area clean.
Wash with water and mild soap, and place wet, cold compresses on blisters several times a day to relieve pain and itching. The baths with oatmeal usually give relief. To avoid spreading the virus to others, keep the rash covered area at all times. Prevention There is no way to completely prevent shingles. The varicella vaccine can cause shingles is less serious. Therefore, if your child has not had chickenpox, it is not too late to ask the doctor to the vaccine. A vaccine against shingles, but doctors only managed to older adults. This is because the higher it is, the more severe shingles. It is very unlikely that the herpes zoster in a child is severe. Children who have a rash of shingles that can not be fully covered, should not attend school or daycare until the blisters have scabs and dry. Newborn babies, pregnant women and anyone whose immune system is weakened, or anyone who is not immune to chickenpox should avoid contact with people suffering from shingles until the blisters have healed completely.
Which is the treatment? You can administer antiviral drugs for the episode of shingles heal faster and the chances of having complications are reduced. However, not all patients have to take antiviral drugs. Your doctor will prescribe the if deemed necessary. If you need to take them, the sooner you take more effective they will be. Antiviral drugs can not eliminate the virus from the body, which means they can not prevent you have more outbreaks in the future. To relieve the pain associated with shingles, doctors or nurses typically prescribe a cream, an aerosol or a patch to numb the skin. There are also prescription and nonprescription pain reliever. Do not take aspirin. Aspirin exposes adolescents to a greater risk of a rare but serious disease called “Reye syndrome. ” If you suffer from herpes zoster that gives you itch, maybe your doctor may recommend creams or medicines called “antihistamines”. Keep the rash area clean by washing with water and mild soap.
Place cold, wet compresses to the blisters several times a day to relieve pain and itching. The baths with oatmeal usually give relief. Is it possible to prevent shingles? There is no way to completely prevent shingles. The varicella vaccine can cause shingles is less serious. Therefore, if you have not had chickenpox, ask the doctor to give you the vaccine. A vaccine against shingles, but doctors only managed to older adults. This is because the higher it is, the more severe shingles. It is very unlikely that a teen shingles is severe. If you get shingles, you can prevent the virus from spreading by keeping the affected area with the rash covered at all times and following a treatment, if needed area. People suffering from shingles should stay away from newborn babies, pregnant women and anyone whose immune system is weakened, or anyone who is not immune to chickenpox, until the rash is gone. Therefore, those affected adolescents shingles should stay home for a while. It all depends on the person and situation.
Your doctor will advise you. Shingles can be scary, but this is due to the way it affects adults. The good news is that the infection usually does not affect adolescents. And even if it affects the adolescent, usually it is not serious.
WHAT IS SHINGLES? In this article, you will find: Definition Remedios NATURAL MEDICINE echinacea Plantain phytotherapy: Folk Remedies: Homeopathic remedies: Oligoterapia Recommended foods aromatherapy
To consider 1. Definition > What is shingles? acute infection caused by the varicella-zoster virus (VZV) that primarily affects adults and is characterized by the development of painful vesicular skin eruptions that follow the path of the cranial nerves or spinal nerves inflamed by the virus. It tends to invade the dorsal root ganglion associated with trigeminal and dorsal. Symptoms: malaise, fever and headache. They can mimic other diseases such as appendicitis or pleurisy. Wikipedia writes: “Shingles is a reactivation of the chickenpox virus characterized by small painful blisters ring-shaped clustered along a dermatome. Colloquially, it is better known as shingles or culebrina, and in some areas of the Mediterranean, such as Italy and Malta , it is known as “St. Anthony’s Fire. ”
Shingles is actually neuropathy, affecting peripheral nerves with or without cutaneous manifestations. Shingles is caused by the varicella zoster virus (VZV). This is a virus of the family of herpesviruses (Herpesviridae); in particular it is classified as HHV-3 or “human herpes virus 3”. VZV is also the cause of chickenpox, skin disease classically child. Therefore, you must have been exposed to chickenpox to develop a herpes zoster. Most people connect with VZV during childhood, though not always have chickenpox (because they have a subclinical picture). The immune system eliminates the virus from the body, although it remains dormant in the nerve ganglia (dorsal root ganglia, off the nerves of the spinal cord). Also it remains dormant in nerve ganglia other body, such as trigeminal ganglion Gasser or other cranial nerves in the head. the immune system usually keeps the virus inactive. When it deteriorated (with certain diseases, age . . . ) the virus reactivates and replicates in neurons, and form new viruses circulating along the axon to the area of skin innervated by that node (dermatome).
Once there, the virus can cause inflammation of the skin with formation of ampollas. El characteristic pain of shingles is caused by irritation of sensory fibers in the infected nerve. Many patients develop a chronic painful condition called post-herpetic neuralgia, difficult to treat. This is more common in the elderly, and can get to incapacitate the patient, given its severity. In some patients, shingles can react subclinical, with pain dermatome without more complicated and affecting more nerves than the initial signs cutaneous herpes zoster (zoster sine herpete). Moreover, in these cases can be complicated by cranial neuropathy, polyneuropathy, myelitis, or aseptic meningitis. In the case of herpes facial zoster, can cause complications such as facial paralysis, usually temporary, decreased hearing or encephalitis (in the so-called Ramsay-Hunt syndrome, involvement VII and IX cranial nerve. The perioftálmico zoster (by involvement of the first branch of the trigeminal) requires urgent eye care, it can lead to eye, such as mucopurulent conjunctivitis, episcleritis, keratitis and anterior uveitis complications. there may be paralysis of cranial nerves III, IV and VI, producing affectation eye movement . A complication potentially serious, but rare, is respiratory failure due to diaphragmatic paralysis, in case of involvement of the vagus nerve or cranial nerve X. Other complications that occur mostly in immunosuppressed individuals are necrotic shingles (with deep and necrotic ulcers, which can lead to bacterial infection); and widespread herpes zoster (in which multiple lesions occur in the affected distance, with hematogenous spread metamere). The Ramsay Hunt syndrome is the association of facial paralysis and shingles blisters affecting the external auditory meatus and / or tympanic membrane. It may be accompanied by deafness, tinnitus and dizziness.
The cause is the reactivation of infection by the varicella zoster virus (VZV) of the facial and auditory nerves. http://es. wikipedia. org/wiki/Herpes_z%C3%B3ster So to summarize, we have a viral disease that affects the imunológico system, the ear and can cause facial paralysis. Is Rectifying this dialog disease remove Remove natural and alternative remedies? Marco sent this very complete information about the treatment of herpes zoster 2. Remedios Taken herbal and natura NATURAL MEDICINE They call it “vegetal antibiotic”, although the term is misused because it does not directly kill bacteria as a classic antibiotic. Its activity explain, according to various investigations, by stimulating the immune system.
http://www. teorema. com. mx/articulos. php? id_sec=46\x26amp;id_art=5101 To make a decoction of Echinacea (Echinacea angustifolia) add 30g of dried plant or 30g fresh to 750ml of cold water plant. Heat until it reaches the boiling point and then let it simmer for 20-40 minutes. Keep the decoction in a jar with a lid and place in a cool place or in the refrigerator for 48 hours maximum. A cup of herbal tea or a glass 3 times a day will help to raise their defenses and reduce the duration of illness. To make a tincture of Echinacea (Echinacea angustifolia) put 15-30 drops using a dropper or a straw in half a glass of water, tea or fruit juice. Take 3 times a day, preferably before meals. A compress Plantain (Plantago major L.
) will relieve significantly the eruption. Soak a clean cloth in warm infusion, wring out the excess liquid and place the compress on the affected area. Like any plant rich in mucilage, it presents a vulnerary and anti-inflammatory property, both internal and external use. This healing property, surely derives against ulcers indication of malignant origin. http://www. mundonuevo. cl/areas/Areas_Tematicas/Terapias_Naturales/plantas_medicinales/llanten. php phytotherapy: Alfalfa (Medicago sativa L. ); Chamomile (Chamomilla recutita L. );
Dandelion (Taraxacum officinale Weber); Cayenne (Capsicum frutescens); Goldenseal (Hydrastis canadensis L); St. John’s wort (Hypericum perforatum L. ); Valerian (Valeriana officinalis L. ); Folk Remedies: If you apply with a gauze leeks juice on the blisters of shingles, you will feel a great relief. Leek juice has excellent qualities for our health, is very rich in nutrients, especially has antioxidant, invigorating and beneficial to the defensive system properties. It is also appropriate to combat arthritis and other inflammatory conditions. It has an onion flavor, but something softer, and it is a nice relaxing for nervioso.
http system: //www. nutriguia. com/ t = STORY; topic = with; id = 200301160001? Homeopathic remedies: Variolinum D30 Mezer. D3-D6 (is the best remedy, also prevents neuralgia) Rhus tox. (Tox) D6-D30 (Suitable for all areas of nerve herpes) Ranunc bulb. (Ranunculus. ) D3-D6 (for herpes intercostal whose pains are accentuated by changing the time or when moisture and relieved by sweating or sleep) Apis mell.
D3-D6 (vesicles, burning, stitches, especially at the beginning of the liver process) Staphys D3 (before the eruption neuralgic pains. Herpes dry. Irritable and cranky patients). Arsenicum album Kalmia latifolia Mezereum Oligoterapia: L-lysine 500 mg twice a day on an empty stomach. Take it with water or juice, not milk. Vitamin C with bioflavonoids. 1000 / 200mg 2 times a day. Complex B vitamins 100mg three times a day.
Zinc. 80mg daily for a week, then reduce to 50 mg daily. Calcium / Magnesium. 1000 / 750mg daily. Garlic. 1000 mg 2 times a day with meals. Beta-carotene 15. 000IU daily. 400 IU vitamin D daily. Vitamin E 400-800IU daily. Kelp; propolis; Pollen; Chlorophyll. Recommended Foods Beer yeast.
Integral rice. Garlic. Raw fruits and vegetables. Fruit juices. Whole grains. aromatherapy: Bergamot Hypericum Eucalyptus Geranium Goldenseal Lemon Lavender
Tea Tree TO CONSIDER As topical antiseptics you can benefit from the calming effects, disinfectants and bactericides of Savory (Satureja montana), Lavender (Lavandula latifolia), Eucalyptus (Eucalyptus globulus), lavender (Lavandula angustifolia), Lemon (Citrus limonum), Mandarin (Citrus nobilis ), bitter orange (Citrus aurantium), Niaouli (Melaleuca quinquenervia), Pino Albar (Pynus silvestris), rosemary (Rosmarinus officinalis), thyme (Thymus vulgaris). Try also apply an emulsion of vitamin A on the affected area which will help soothe irritation and pain. Caution: Do not take drugs containing acetaminophen (Tylenol). Try to keep stress levels to a minimum. Frequent showers cold water help relieve pain. Avoid drafts. Expose the affected area to sunlight for 15 minutes each day area. Wash blisters every day. Avoid touching or scratching them. And plenty of rest . .
HERPES ZOSTER Definição Or Herpes Zoster é uma infectious, contagious and painful doença caused mesmo hair vírus da Chickenpox Rushing nervos, lymph and pele, decorrente gives reativação do not adult latent virus, which causes or aparecimento of extremely painful vesicular erupções ao longo da via two nervos peripherals to peel off. Or viruses do herpes zoster reativado é também we imunocomprometidos patients suffering from chronic patients com doenças and neoplasms (cancer). We particularly patients vírus gives com or AIDS, to doença que é uma geralmente benign pode apresentar serious and fatal cases alguns evolução em. A doença é considered infectious Primeiros us just 2-3 days, and just for you gizmos com imunossupressão, ou que não aqueles tiveram for chickenpox before. There Tendência uma maior complicações and dry them not mais idoso patient. Synonymy É também uma doença conhecida popularly seguintes hairs nomes: · Cobreiro. · Zone. Incidence · Em mais Ocorre adults.
· A maioria two adults são imunes year shingles, pois já adquiriram you anticorpos quando na tiveram infância chickenpox. · Or virus herpes zoster tem estreita do ligação em com neoplastic patients doenças (cancer) and to AIDS · Patients com HIV positive, tem uma large predisposição to acquire herpes zoster. · Só quem tem já teve herpes zoster chickenpox. etiologic agent Varicella-Zoster Virus; família Herpetaviridae; RNA viruses. fisiopatologia Quando or viruses and ativado, alguns em desconhecidos fatores cases are multiplicam and Migram terminações pelas nervosa, giving às lesões ou em uma snaking feature outros podem cases apresentar isoladas lesões. Após 24-hour period um ou mais, começam to appear on lesões as, vesicles arredondadas that depois 5 to 6 days começam break, dry and crusts will transform em amarelas escuras, resulting da da pele Local necrotic. is as lesões atingirem to região da epiderme só não havera scars, but is deeply derme atingir mais pode or riding cicatrizações dependendo do grau of ulceração das lesões. Geralmente attacks or nervo next trigêmeo da orelha tied to testa, no chest segue Espaços hairs intercostais começando região pela da espinha seguindo em direção year esterno, também pode attack or bouquet ophthalmic nervo do trigêmeo, to região da neck ea região genital tied to root da coxa. Após to phase haematogenous atinge to disseminação em pele, or segue vírus peripheral lymph até os nervosos nervos hairs onde remains latent em all to life do individual. reservatório
O Homem. Duração period Em average of 4 to 6 weeks Period incubaçao Em average of 7-21 days quando uma mow quick febre, nesse period appear. Fatores from crag São aqueles fatores ou doenças that podem exercer ativante Efeito on or latent virus is not organism: · Diabetes. · Stress. · Lesões do nervous system. · Neuropsychiatric disturbances. · Tumors da cord. · Leukemia.
· Trauma. · Febre. · Queimaduras sun. · Saúde oral problems. · Pós-Cirúrgicos problems. localização · Região Thoracic (53%). · Cervical Região (20%). · Região do nervo trigêmeo (15%). · Região lombossacra (11%). clinical forms · Herpes zoster hemorrhagic: quando Contem as small vesicles sangue from lesados vessels. · Gangrenous Herpes zoster: as vesicles transformam ulcerações em deep.
· Ophthalmic herpes zoster: ophthalmic atinge or bouquet quando não nervo do trigêmeo was treated for levar pode à Cegueira. · Ramsay-Hunt syndrome: comprometimento do geniculate ganglion, lesão not pavilhão and ear headset Conduto; Prune cause gustatory sensação perda gives us previous 2/3 da língua and facial hemiparesis. ophthalmic herpes zoster Or herpes zoster não afeta necessariamente or olho, quando ocorre mesmo na na fronte and face. No entanto, quando ophthalmic divisão do nervo fifth cranial becomes infected, é provável that spread infecção até o olho. A inflamação cause dor, hyperemia (excesso of sangue) and eyelid edema, and prune engage cornea, acarretando to formação of scars. We em who has scar cases, prune-be used or meio of tratamento mais end, or corneal transplantation. As you structure located behind da cornea podem inflame uma defined condição of uveíte, and ocular pressão prune increase, causing glaucoma. As complicações Communes of infecção uma da incluem perda cornea and sensibilidade year or permanent touch and glaucoma. Herpes zoster Quando o infects face and ameaça or olho, or tratamento precoce com or antiviral acyclovir administered orally during sete dias, reduz or crag complicações eye. I Corticosteroids, geralmente to sob as eye drops, também podem be úteis. Frequently, são atropine eyedrops used for manter a dilated pupil and, também for ajudar to prevent or increase olho da pressão do. Sinais and symptoms
initial period: · Febre discreet; · Cefaléia; · Local sensibilidade prurido ou; · Irritabilidade; · Mal-be geral and indisposição; · Increase tamanho do two lymph nodes; · Riots gastrointestinais pode precede erupção; · Sensação chopped, formigamento, and nonlocal queimação onde as aparecerão lesões. ocular herpes symptoms do Iniciais: · Dores olhos us. · Lacrimejamento. · Sensibilidade to light.
· Hyperemia. exantemático period: · Erupções skin and vesicular erythematous base on unilateral uma grouped ao um level gives inervação of nervoso bouquet, acompanhada dor irradiating all or trajeto atingido nervo do; · As erupções vesicular dispõem-se em FAIXAS of alguns centimeters in length ao longo da area distribuição do nervo afetado, just em uma das Metades do corpo, sem ultrapassar to medium Linha. As vesicles, dispostas em erythematous bases, grupam-se em horns, tendendo to Confluence. · Dor to prune intensidade vary, ranging from moderate dor até o ponto da dor will turn insuportável, sensação com uma forte queimadura during and depois das erupções. convalescença period: · Após to break das vesicles (4-5 days) formação of crusts, which desprendem and deixam uma escura stain. Prune persist nonlocal dor by algum tempo; · Or tempo of cicatrização das vesicles ranges from 7-20 days. Diagnosis · Physical Exame. · Clinical Exame (pelas features das lesões).
· Exames laboratoriais. · Testes sorológicos (specific research anticorpos against or viruses). · Testes virological (viral isolamento by inoculação em cell cultures). · É prudent to Realização of estudos diagnoses to investigate Possibilidade de uma subjacente doença. Obs: Herpes zoster or prune tell uma presença of serious internal doença, especially após to meia-idade, Doença as lymphoma, leukemia and alguns types of neoplasms (cancer). Or deve fazer doctor exames to tempt detect Essas doenças. differential diagnosis O differential diagnosis deve ser feito não seja for or Herpes zoster confused quadro com outras com semelhante clinical pathologies. Through two clinical exames, physical, and radiological or medical laboratoriais estudos pode exclude Essas doenças, até chegar ao correto diagnosis. As doenças that podem be confused com or Herpes zoster seguintes são as: · Variola. · Eczema vaccinatum. · Eczema herpetic.
· Rickettisiose varicelliform. · Impetigo. · Infecção coxsackievirus. tratamento Objective: Or do target tratamento dor é eliminate and prevent Infecções secondaries. · Symptomatic: as you apresentados symptoms and medical indicação suas intercorrências sob. Analgesics são indicated to relieve dor, medical indicação sob. · São Antibiotics used to prevent Infecções secundárias das vesicles, medical indicação sob. · Anti-inflammatory sob são medical prescrição indicated to avoid inflamações. · Anti-histamines sob medical prescrição podem be indicated to control or prurido. · To control or nervousness that acompanha to neuralgia and or prurido, specific medicação deve be administered, medical prescrição sob. · Soluções anti-septic lesões nas ajudam prevent Infecções. · Analgesic com ou também são antibiotics used to avoid bacterial contaminação Ointments.
· Talc antipruriginoso banho após or alleviates or prurido. · Uma once tendo or herpes zoster or patient acquires Immunity Challenge. · Ao treat or patient deve-se luvas, mask and hat use. · Moderate Repouso not leito é recomendável. · Os com podem patients see and feel dermatological problems seus problems, and you’re afetam mais do that carriers outras muitos of pathologies, by isso or psychological apoio by é da equipe of enfermagem esses critical to patients. Obs: Quanto mais precoce or diagnosis, and rapid seja mais implemented or tratamento, lower to destruição do nervo and less or patient sofrerá com dor-herpetic pós. Complicações · Nevralgia pós-herpértica (NPH – that remains persistent dor 4 to 6 weeks, more cases prune alguns em stay for several months, logo após to erupção Dermal). · Encefalite (severe cases). · Infecção bacterial secundária, decorrente das lesões skin. · Quando há Paralisia peripheral facial or cranial pair VII envolvimento do. · Artrite granulomatous. · Quando ocorre Herpes zoster ophthalmic em pode be inflamações, ulcerações podendo evoluir chegar até à Cegueira.
· Em HIV positive patients com complicações as seguintes são as: retinite, acute necrotic da retina, encefalite progressiva. dry them Ophthalmic herpes zoster: · Perda of sensibilidade to or touch. · Permanent Glaucoma. · Cicatrizes na cornea, which podem fazer com or patient that tenha to go to or corneal transplantation. · Cegueira. gerais care · Wash year as mãos semper em contato com or enter patient. · Não deve manter contato com or liquid das vesicles. · Avoid touching lesões ace, ace furar as bolhas and start crusts. Dúvidas technical and expressões, see Glossary geral or thermos.
Feature: Shingles is an infectious disease caused by the varicella-zoster virus herpes virus group. The infection develops in two stages: primary infection, which is typical of childhood and is known as chickenpox. This disease occurs during life only once. During primary infection the virus travels through the sensory nerve from the skin to the lymph where he remains in a latent phase. Replication (multiplication) of the virus is suppressed by the cellular and humoral immunity. The second stage occurs immunity disorder (especially cell) when it could produce virus reactivation. After the virus travels along the nerve to the skin, which is accompanied by a field of vesicles in a dermatomal skin and shingles occurs. This condition may arise due to aging, stress, trauma, cytostatic or immunosuppressive therapy, cancer, inmunodefecto or after radiation. Under normal circumstances the reactivation occurs during life only once. Relapses of shingles are very rare, however may indicate the possibility of cancer or AIDS. The typical place of appearance of shingles is where they spend the intercostal nerves in the chest and some parts of the face around the first branch of the trigeminal nerve. Risk of these complications in people who have not yet had chickenpox and can be infected for the first time by the varicella zoster virus or pregnant women can endanger the fetus by contact with a sick are, etc. The most serious complication is post-herpetic neuralgia.
Treatment consists of antiviral drugs analgesics, anti-inflammatory ointments, vitamins and. Vaccines are used successfully especially against serious forms of the disease. Using magnet therapy Effective prevention of shingles may be the strengthening of general immunity. The low-frequency pulse magnetotherapy Biomag is a suitable method that complements the overall patient care, relieving pain, accelerating healing and regeneration, and stimulating the immune system. Mode of application In the acute phase applied daily and repeatedly with analgesic frequencies 4-6 Hz and convalescence frequencies 50-81 Hz with stimulating effect. It applies in painful seeding places and in the segment of the spine with a flat applicator. Magnet therapy and shingles – its consultations Want to learn more about the application of magnet therapy to treat shingles? Do not hesitate to contact us. We answer your questions about the use of magnet therapy in shingles.
HERPES ZOSTERSinônimo / popular nome: Cobreiro. O I É uma é da reativação doença decorrente do vírus gives chickenpox (varicella-zoster virus) latent em, adults and patients who afeta com comprometida. Como Immunity is desenvolve ou acquires various causes? podem cause reativação do uma virus causing herpes do erupção zoster. Não existem evidence that possa uma pessoa develop shingles as a result do contato com ou patient varicella zoster com. More or contato com as lesões skin direto prune transmissão be na uma pessoa of chickenpox suscetível. Em Geral do quadro não há recorrência shingles; only 5% podem ter recorrência two patients, usually no mesmo local. Qualquer pessoa that direction tenha suscetível é ter varicella herpes. Em geral são mais com adults 50 years and incidence increases to avançada idade com. Também é mais comum em pessoas com sua doenças that alterem Immunity, as descrito. O já that present? Antecedendo lesões as pele, you referem patients muitas vezes dis-ease, dor cabeça, febre, nevrálgicas ers (we nervos) perda of sensibilidade, ardência and locais coceira. A typical é uma lesão vesicle (small bolha) based on avermelhada uma na pele, em em geral groups coalescentes.
Surgem gradually, levando two to four days to be estabelecerem. Quando não ocorre infecção secundária by bacteria, as vesicles “secam” or quadro forming crusts and evolui for a cure em 2 to 4 weeks. As regiões committed são mais thoracic, cervical (pescoço), trigêmeo (face), and lombo-sacral (waist baixo) patients . Em com Immunity altered podem arise atypical em localização e erupção is disseminar. A unilateral and rarely ultrapassando to linha média, seguindo or trajeto of nervo. A dor é um pretty intense, não é rare for a erupção of pele, embora geralmente diminua us com patients less than 50 years and as a doença melhora. Em com mais patients 50 years , to prune persist dor cured depois lesões as of pele – é a nevralgia chamada pós-herpetic. A nevralgia pode ser uma seqüela to prazo longo, em ocorrendo 10 to 15% two patients, increasing to idade com. Na das vezes maioria is spontaneously resolve within two Primeiros 12 months, more pode persist for years. A dor é com intense and debilitating frequency. Prune is manifest combinações of coceira com, com ardência perda local sensibilidade and sudden and sharp intense ers. Um light touch nonlocal um pode induzir to face or discomfort experienced acentuado. Como is diagnosis?
Or das lesões typical aspect é, em geral, for or diagnosis of herpes zoster. Existe pigtail um exame do material gives base gives vesicle (small bolha) I and unspecific, Sendo you mesmos Achados for varicella, herpes simplex and zoster. Como is it? As auxiliam and symptomatic measures são muito efficient mainly gives relief dor. A no antiviral therapy, não em Infecções complicated, accelerates cicatrização, reduzindo or number and days of lesões desenvolvimento novas and relieving dor do zoster. A useful and antiviral therapy was initiated within 72 hours depois das primeiras início do das lesões of pele e pode be muita importance we com mais patients 50 years ou imunocomprometidos. Como be warned? Recentes Estudos e amplos têm demonstrated to utilidade da vacina against chickenpox na das redução complicações do herpes zoster and postherpetic neuralgia given mainly of avançada pessoas em idade (maiores 60 years) . A vacina varicella é na infância rotina recommended. Ela pode também be recommended for adults who never had chickenpox tenham.
What is it? Shingles is an acute infection caused by the varicella-zoster virus (VZV), which affects mostly adults. It is characterized by the development of rashes in the form of blisters or painful blisters, which are located along the course of some inflamed nerve also by the virus. Because this particular arrangement infection is popularly known as ‘ringworm’. This is the same virus that causes chickenpox. After chickenpox, the virus is not eliminated from the body and remains inactive (dormant) in certain nerves. Shingles occurs when the virus reactivates in these nerves after many years. The reason why the virus becomes active again unclear. Often, only one episode occurs. Shingles can develop in any age group, but one is more likely to develop the condition if: It has more than 60 years. He gave chickenpox before their first birthday. Your immune system is weakened by medication or illness.
If an adult or a child have direct contact with the shingles rash and did not give them chickenpox as a child or received the chickenpox vaccine, they can develop chickenpox, not shingles. What are the symptoms? The first symptom is usually a pain on one side of the body, tingling or burning. Pain and burning may be severe and usually occur before any sign appears on the skin. The typical rash are small blisters that occur within two or three days, when the virus reaches the skin. The blisters break, forming small ulcers that begin to dry and form scabs, which can fall off in two to three weeks. It heals without scarring. The lesions appear on one side of the body and generally can be displayed on the trunk a belt of rash from the spine around one side of the chest. You can also appear on the neck or face affecting the mouth or eyes. Which is the treatment? Usually it is a problem that usually persists for about a month until it disappears by itself, although they can put in place measures to treat the symptoms. However, in some immunocompromised or elderly patients, complications may occur, such as post-herpetic neuralgia (persistent pain or burning 30 days after onset of herpes zoster), which can be disabling. The treatment is based on the use of antiviral drugs such as acyclovir, which must be indicated by the Physician.
If the correct doses are used pain decreases rapidly and the chances of complications are reduced. It is best to begin treatment in the early hours of first feeling pain or burning to get better result. To reduce pain analgesics are used. Availability of a vaccine against herpes zoster and is different from the chickenpox vaccine. Older adults who get the vaccine against shingles are less likely to have complications from the disease. Dra. Anabel ManzoneCordoba 2518 TE: 4925366 4951585
From Wikipedia, the free encyclopedia Herpes zoster on a patient’s neck Herpes zoster (Also known as Shingles or Zone) is a disease in humans. The same virus causes chickenpox Also That causes shingles. The symptoms are pain and a rash With blisters. General information Shingles is a viral disease produced by the varicella zoster virus (VZV), the same virus That causes chicken pox. Its symptoms include pain and a blistering rash along the nerves That OCCURS That Contain dormant virus. You can not catch shingles. However, you can catch chicken pox through direct contact With Someone who has shingles, by touching the area of the rash. Most People Who get shingles are old. It Infects Sometimes younger people, or people with a Weakened immune system. Stress May trigger shingles.
The disease Starts With tingling, itchiness, or pain on an infected person’s skin. After a few days, the disease causes a blistering rash. This May be rash on the trunk or face. The rash grows into small blisters filled with fluid. These blisters dry out and crust over for Several days. The rash causes anything from mild itching to extreme pain. The rash stays in one region of the body. The shingles virus is contagious from person to person by direct contact only. For This reason, persons are advised With shingles to limit Contact with Those Who are not immune to chicken pox, Those With Increased risk are young children and pregnant women. When one Contracting chickenpox is pregnant can be dangerous to the unborn child. If people Have had chickenpox, They can not get chickenpox from someone else again. However, it is thought That contact with a shingles patient May trigger a person’s own dormant chickenpox virus to Become shingles. Treatment
Doctors recommend antiviral drugs, steroids, antidepressants, anticonvulsants, and topical agents to treat shingles. The antiviral drugs acyclovir, valacyclovir, and famcyclovir can reduce the severity of shingles. prognosis Shingles can be very painful and itchy. It is not very dangerous to healthy people, and it ends without major problems Usually. The rash and pain last 3 to 5 weeks. Sometimes, serious problems like temporary, partial facial paralysis, ear damage, or encephalitis May occur. Persons With shingles on the upper half of the face need immediate medical attention: the virus May cause serious damage to the eyes. Most people Who Have Have only one shingles attack of the disease in Their lifetime. However, People with AIDS, cancer or weak immune systems May Have multiple attacks. Other websites NIH Facts About Shingles NINDS Shingles Information Page
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It is a disease caused by a virus that usually affects people over fifty years or a depressed immune system by different causes (stress, emotional trauma, AIDS, cancer, aging, flu-like processes, colds, etc. ) The same virus that chicken pox The causative agent is the same virus that chicken pox: Herpes Varicella-Zoster virus. For a person suffering from herpes zoster first must have had chickenpox. The herpes zoster virus can also infect people who have not previously had chickenpox in this case give rise to intense outbreaks of chickenpox. Not all people who have had chickenpox will suffer in the future of herpes zoster. Incidence The incidence of herpes zoster in Europe in general population is between 300 cases / 100,000 inhabitants / year. These figures increase from 60-65 years to stand at 1,000 cases / 100,000 inhabitants / year in patients older than 80 years (Volpi A, 2005). The incidence of herpes zoster and postherpetic neuralgia increases with age (> 60 years) and with diseases that weaken the immune system. Why herpes appears? It is having had chickenpox the virus remains dormant in nerve cells state.
This latency can last for years until the virus becomes reactivated. When the body’s defenses are down this virus uses to reproduce. How is it spread? It can be spread through direct contact with the person with herpes. unspecific symptoms at first At first only it appears a burning sensation, pain, burning, itching or stinging in the area supplied by the affected nerve. It may be accompanied by fever, swollen lymph nodes or joint pain. Then, usually at 4 or 5 days, a reddening of the area appears and blisters begin to appear characteristics that follow the path of a nerve. These lesions take the form of a species of snake or shingles (popular name that is known to herpes zoster). These injuries can take weeks or months to heal (depending on factors such as age, state of defenses of the patient, etc. ). Where the shingles may appear? The most common area is the intercostal region affecting one side of the chest.
It can occur in any area of the body, leg, genitals, face, neck . . . When the virus affects the trigeminal nerve in the face can cause facial paralysis, difficulty closing the eye, his mouth twisted and even blindness. It can cause deafness when the affected area is the ear. It can cause alterations in taste when the affected nerve is the tongue. When it affects the brain can cause herpes encephalitis. In people with very low defenses can affect various parts of the body at once. PHN It is the most common complication occurs between 8 and 25% of cases. It is more common in those over 60 years. Pain persists when cured skin lesions and is a most important nervous system damage. The pain is usually intense, sometimes burning with intense sensitivity in the affected areas.
It may be accompanied by unpleasant sensations such as tingling, itching, numbness, burning, etc. PHN can cause muscle spasms, which will increase the pain even more. They can also appear visceral disorders, insomnia and depression. The sick sometimes feels misunderstood by his family and he does not understand why skin lesions are already cured and yet, the pain persists intensively. other complications The sobreinfeción of skin lesions. Complications in the eyes may appear uveitis or keratitis. Neurological complications: motor neuropathy, meningitis. Complications at ear level or associated with facial paralysis. Know more Herpes zoster and post-herpetic neuralgia: treatment Herpes zoster Herpes zoster
Herpes zoster: herpetic neuralgia Herpetic neuralgia and herpes zoster See this article without having to be connected, free download it here in PDF format: Herpes-zoster. pdf consult In the same category Posted by DRA. MARNET.
What is shingles? Shingles is a skin infection caused by a virus called varicella-zoster. The virus is so named because it is responsible for both chickenpox and herpes zoster. In most cases, contact is made with this virus during infancy, then the child suffering chickenpox. This disease is characterized by pustules and fever and usually benign. Once cured infection, viruses migrate from the nerve endings of the skin to the spinal ganglia where they remain dormant. Aging or by decreasing the patient’s defenses, the viruses are reactivated resulting in the called herpes zoster. Colloquially, it is more commonly known as shingles or culebrina, and in some areas of the Mediterranean, such as Italy and Malta, is known as “St. Anthony’s Fire” What are the symptoms? When the virus reactivates from the nerve ganglia they migrate to the skin. Depending on the location of the nodes involved, the virus will go to the territories of the skin innervados by these (these are called dermatomes). The patient has a sensation of pain or itching in these areas (especially on the trunk and face) and at 4 or 5 days a vesicular rash occurs.
During this phase, the lesions are highly contagious. After 7 to 10 days the lesions dry brown scabs forming, after falling sometimes leave a residual scar. In many patients, the disappearance of the infection remains a residual pain in the affected area, pain that can be severe and permanacer for weeks or months. This pain is called post-herpetic neuralgia and can be disabling How it is diagnosed For the doctor, the characteristic symptoms presented by the patient is usually sufficient to diagnose the disease. Only in rare cases some tests may be needed, such as taking a sample of fluid from pustules to cultivate and identify the virus Which is the treatment? Shingles is a disease that resolves spontaneously after a week in normal patients. However, should the administration of antiviral drugs orally (brivudine, acyclovir, valacyclovir, famciclovir) as these drugs reduce the duration of disease and especially post herpetic neuralgia la. In immunosuppressed patients antivirals are administered intravenously to prevent the virus from spreading to other organs (p. Eg. The brain where they can produce encephalopathies)
It is important to note that the treatment is effective if started within 72 hours of the onset of the rash and to be avoided superinfection of lesions using topical antiseptics The post-herpetic neuralgia, when developed, can be difficult to treat. They are commonly used painkillers from paracetamol (a drug that is acquired at the pharmacy counter) to tramadol (which must be prescribed by the doctor). If no improvement is used with other drugs such as antidepressants or anticonvulsants. Ultimately, it may be resorted to nerve blocks by injecting local anesthetic or local treatment with capsaicin or other drugs. What is the prognosis? Shingles is usually self-limiting that resolves spontaneously within one or two weeks. In immunosuppressed patients the prognosis is worse because of the possibility that the infection spreads. Hence the importance in treating these patients as soon as possible with antiviral drugs. When herpes is localized in the ocular region, herpes oftálimico may even cause blindness may occur. In these cases it is important to use local antiseptics to prevent spread. During the eruptive phase, shingles is contagious. Avoid contact with others, particularly in immunocompromised patients and pregnant women
What is my risk of developing herpes zoster? Anyone who has had chickenpox in childhood (up to 90% of the population) runs the risk of herpes zoster. The most important risk factors are: Age: Although shingles can occur at any age, as you get older there are greater chances of developing the disease. In a survey made in 9000 patients with herpes zoster, more than 70% had more than 50 years. This is because, with age, are decreasing the body’s defenses against infections. The post-herpetic neuralgia, which is the most common sequela of the disease also occurs more frequently in older people Immunological situation: patients with a weakened immune system (either by the presence of other diseases or by some anticancer medications) are more likely to experience a herpes zoster. Similarly, patients who have received a transplant and received immunosuppressive medication and AIDS patients are at increased risk of developing the disease What are my chances of getting a cold? The next following calculator will make a calculation of the odds you have to have a herpes zoster What can happen to my baby if I get sick of shingles during pregnancy? Most women are immunized at the time of pregnancy.
A small percentage may develop chickenpox (7 per 10,000). If the disease is contracted in the first 20 weeks of pregnancy, the fetus may develop a embrionopatía congenital varicella or varicella syndrome. This syndrome scarring skin lesions, hypoplasia of limbs and other injuries to the eyes and central nervous system characterized. If the fetus is infected, the prognosis is pretty bad. The possibility of a Herpes Zoster develops during pregnancy in even lower and only affects 1 in 10,000 pregnant women. Moreover, the risk that the disease affects the fetus is practically nil since these women have antibodies against the virus (having had chickenpox in childhood) that are sufficient to protect him. In the event unlikely that contracted Herpes zoster During Pregnancy I can take medicine? Antivirals such as acyclovir or famciclovir can be used without risk to the fetus. These drugs reduce disease duration and intensity and duration of post-herpetic neuralgia. In 1993 the Center for Infectious Diseases in Atlanta (USA) published in report in which it claimed that acyclovir without risk when administered during the first trimester of pregnancy I have had chickenpox in my childhood Is there any way to know if I’m getting shingles? There is no way to know if this will happen. The information that scientists have is that the probability of getting the shingles increases with age and that about half of people who reach age 85 have suffered from this disease at some point in their lives
How post-herpetic neuralgia pain? To measure the intensity of pain, scientists use a numerical scales. The best known is the “visual analogue scale” call is used in patients over nine years able to use numbers to express the pain. On this scale, 0 expresses the absence of pain and 10 excruciating pain that requires immediate intervention. For children there is a graphic scale using the face of a puppet for the child to indicate which believes that best fits the pain. Using these scales, scientists have concluded that the intensity of the pain of PHN is located in the vicinity of pain in fibromyalgia and is superior to pain during childbirth or after surgery. The pain of PHN is only surpassed by that occurs during renal colic or after a hysterectomy. How PHN can last? The post-herpetic neuralgia is considered a chronic pain and its duration ranges from several weeks to several months (up to 6 months or more). Moreover, the duration of neuralgia also depends on the age of the subject is estimated that approximately 50% of patients over 80 years, neuralgia lasts an average of 2 months, and up to 6 months in 20% thereof. At age 60, “only” 30% of patients have a neuralgia of a duration of 2 months and only 10% of them this extends to 6 months How I can know if I have suffered from chickenpox in childhood? If you were born before 1977, which began marketing the varicella vaccine is likely to suffer chickenpox, as this disease affected 90% of the population.
If you suffered, you may have the herpes zoster virus dormant that could be reactivated, but also has varicella antibodies that your body developed in his day. If the doctor considers important may request that the title of varicella antibodies in blood check. The determination of antibody titer varicella also will let you know if it was or not vaccinated for chickenpox Are there other complications as well as post-herpetic neuralgia? bacterial superinfection can occur in lesions caused by the virus. But in addition, the virus can invade other organs, either through nerves or spread of viruses from the vesicles. One of the most common complications is ophthalmic herpes zoster affecting the territories surrounding the eye, but occasionally affecting the same eye, to produce even blindness Other less common complications can occur at the level of the viscera (esophagitis, pericarditis, hepatitis, etc. ) or at the level of the nerves or the central nervous system (meningoencephalitis, cranial nerve palsies. Etc.
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More images of herpes zoster (shingles) alternative names Shingles Definition It is an acute, localized infection with varicella zoster virus, which causes a painful, blistering rash. Causes and risk factors Or shingles Shingles is caused by the same virus that causes chickenpox. After an episode of chickenpox, the virus becomes dormant in the body and shingles occurs as a result of the reappearance of the virus after many years. The cause of the reactivation is usually unknown, but appears to be associated with aging, stress or immune system disorders. Usually only an attack without relapses occur. If an adult or a child who has not had chickenpox in childhood or been vaccinated against this disease exposed to the herpes zoster virus, may develop a severe case of chickenpox instead of shingles. After infection with chickenpox, the virus resides lethargic in the nerve pathways emerging from the column. When reactivated, it spreads along the nerve tract, first causing pain or burning sensation.
The typical rash appears two or three days after the virus reaches the skin and consists of red patches on the skin with small blisters (vesicles) which are very similar to chickenpox in its initial stage. Often the rash is maximized within three to five days and then the blisters break forming small ulcers, which begin to dry and form scabs, which in turn emerge in two or three weeks and leave the pink skin in healing process. Lesions typically appear along a single dermatome (body area served by a single spinal nerve) and are only on one side of the body (unilateral). The trunk is the most commonly affected area, showing a rectangular belt erupting from the spine, around one side of the chest to the breastbone. Lesions may also appear on the neck or face, particularly in the trigeminal nerve in the face. The trigeminal has three branches: the top that goes to the front, the average going to the central part of the face and the bottom to the bottom of it. The commitment to a branch is involved determines where on the face the skin lesions. Trigeminal nerve can produce lesions in the mouth or eyes and eye injuries can lead to permanent blindness if not treated with emergency medical care. The commitment of the facial nerve may cause Ramsay Hunt syndrome with facial paralysis, hearing loss, loss of taste in the middle of the tongue and skin lesions around the ear and ear canal. The disease can sometimes involve the genitals or upper leg. Herpes can be complicated by a condition known as post-herpetic neuralgia, a persistent pain in the area where the herpes, which can last from months to years after the initial episode occurred. This pain can be severe enough to incapacitate the person and the elderly who are at increased risk of this complication. Shingles can be contagious by direct contact for an individual who has not had chickenpox and therefore has no immunity.
Shingles can attack at any age, but is most common in adults over sixty years, children who had chickenpox before one year of age or individuals whose immune system is weakened. The disorder is common, with about 600,000 to one million cases in the United States each year. The most common is that a herpes outbreak is localized and involves only one dermatome. Widespread or recurrent herpes may indicate an underlying disorder in the immune system, such as leukemia, Hodgkin’s disease and other cancers, atopic dermatitis or HIV infection or AIDS. People with suppressed immune systems due to organ transplant or treatment for cancer are also at risk. symptoms Warning symptoms of unilateral pain, tingling or burning sensation limited to a specific part of the body: pain and burning sensation may be intense. Skin redness (erythema) followed by blisters (vesicles) small blisters (vesicles), clustered, dense and deep that ooze and crust over Other symptoms that may be associated with this disease: Fever, chills General ill feeling Headache
Swollen lymph nodes Vision disorders Abnormalities in taste Drooping eyelid (ptosis) Loss of eye motion (ophthalmoplegia) Hearing loss Joint pain Genital lesions (male or female) Abdominal pain Signs and tests The diagnosis is suspected based on the appearance of skin lesions and reinforced with a history of chickenpox or shingles. It can be confused with herpes simplex. Tests are rarely necessary, but may include:
Viral culture of skin lesion Tzanck examination of skin lesion CBC may show elevated GBS, a nonspecific sign of infection Measurement of antibodies (immunoglobulin) Specific: shows elevated antibodies to chickenpox Treatment Shingles usually disappears on its own and may not require treatment, except for symptomatic relief, in which case drugs are used for pain. In cutaneous herpes, it is useful idoxuridine (virexen). brivudine (nervinex) Acyclovir is an antiviral drug that can be prescribed to shorten the course, reduce pain, reduce complications or protect an immunocompromised individual. Desciclovir, famciclovir (ancivin, famvir), valacyclovir (valherpes, valtrex, virval) and penciclovir (Vectavir) in cold sores, are similar to acyclovir and can be used to treat shingles. For greater effect, treatment with acyclovir-like medications should be started within 24 hours of the onset of pain or burning sensation and preferably before the appearance of the characteristic blisters. Typically, drugs are available in pills, in doses four times greater than those recommended for herpes simplex or genital herpes. Severely immunocompromised persons may require therapy with intravenous acyclovir.
Sometimes it is associated lysozyme Corticosteroids, such as prednisone, may occasionally be used to reduce inflammation and risk of post-herpetic neuralgia. These have proven to be more effective in the elderly, but have certain risks that must be weighed before indicate them. Analgesics may be needed to control mild to severe pain. Antihistamines can be used in oral topically (direct application to the body) or to reduce itching. The Zostrix, a cream containing capsaicin (an extract of pepper), can possibly prevent PHN. They can be used wet and cold compresses to reduce pain. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or lotions and calamine lotion can help relieve itching and discomfort. Likewise, the rest is recommended in bed until the fever goes down. You should keep your skin clean and not reuse contaminated items. Similarly, non-disposable items should be washed in boiling water or otherwise disinfected before reuse. The person may need to be isolated while lesions are oozing to prevent infecting others, especially pregnant women. Forecast
Shingles usually disappears in two or three weeks and rarely recurs. If no compromise of the motor nerves (the nerves that control movement) can cause nerve paralysis (weakness or paralysis) temporary or permanent. Neuralgia (continued nerve pain) may persist for years in 50% of those over sixty years old who have herpes, particularly if the trigeminal nerve was affected. The eye injuries can lead to permanent blindness and require emergency medical attention. complications PHN Secondary bacterial skin infections Comeback (rare) generalized infection, visceral organ injuries, encephalitis or sepsis (in immunosuppressed people) Blindness (if lesions occur in the eyes) Deafness Loss of Taste facial paralysis
Call your health care Call your health care provider if symptoms indicate the presence of herpes zoster, particularly if the person is immunocompromised or if symptoms persist or worsen. Prevention If the person has never had chickenpox or have not had the vaccine against this disease, you should avoid contact with skin lesions of persons having known herpes zoster infection (shingles or chickenpox). This is especially true if the person is immunocompromised. The varicella vaccine is a vaccine that is recommended in childhood and may be indicated for adolescents or adults who have never had chickenpox. A comprehensive and recent clinical study showed a significant reduction in complications of herpes zoster and the incidence of postherpetic neuralgia in older adults who received the vaccine. Therefore, the elderly (over 60 years) should receive the vaccine as part of routine medical care. REFERENCES MEDLINE. Medical Encyclopedia. http://www. nlm.
nih. gov/medlineplus/spanish/encyclopedia. html 2008 2008
JAMA Patient Page JAMA. 2011; 305 (2): 212. /jama. 302. 1. 112 Shingles Janet M. Torpy, MD, Writer; Alison E. Burke, MA, Illustrator; Robert M. Golub, MD, Editor KEYWORDS: SHINGLES, HERPESVIRUS 3, HUMAN, neuralgia, postherpetic, PAIN, VIRUS DISEASES.
Shingles is a painful condition That Caused by the virus causes chickenpox Present (varicella-zoster virus, or VZV). It Affects About 1 million per year Individuals in the United States alone. Shingles, herpes zoster Also known as, OCCURS in Personalities Who Have Already HAD chickenpox. Most Individuals WHO Develop shingles are older than 50 years, have other medical problems handler (such as cancer), or are immune-suppressed from medications They take handler (such as steroid medications). The virus (VZV) Causing shingles and chickenpox is a type of herpes virus. It is a herpes virus different from the ones responsible for cold sores or genital herpes for. VZV remains in nerve tissue after a person recovers from chickenpox. The virus remains dormant (inactive) reactivated to cause shingles Until. The cause of esta reactivation is not completely Understood. The January 12, 2011, issue of JAMA includes an article about shingles. This Patient Page is based on one with previously published in the July 1, 2009, issue of JAMA. SIGNS AND SYMPTOMS • Rash on one side of the body or the face
• Develop That Blisters in the rash site and then a crust over • Pain, Often a tingling-type pain, can Occur before the rash Appears. • Fever, headache, fatigue, and chills May occur. TREATMENT • Antiviral medications, if taken soon after symptoms begin, can shorten the length of time a shingles episode lasts. The severity of the episode May Also be less if antiviral medications are taken. • Supportive care, treats including rest and plenty of liquids, is useful in the treatment of shingles (like any other viral infection). • Acetaminophen May help reduce fever and pain relief, if it is present. • Cover blisters are crusted Until They over. They do not scratch blisters, since then a They can become infected. • Wash hands faq frequently. • In rare cases, shingles can be severe and cause critical illness, treats including pneumonia or encephalitis (inflammation of the brain). Severe episodes of shingles May require hospitalization for more intensive treatment.
PREVENTION Vaccines are available for chickenpox and shingles for. Varicella vaccine (for chickenpox) is recommended for children and for adults Who Have not Already HAD chickenpox. Shingles vaccine is recommended for adults older than 60 Who are years. Certain Individuals Should not Have These vaccines: pregnant women, persons With disease immune system, and infants younger than 12 months. Persons Who Have shingles can pass on to others VZV Who Have not HAD chickenpox. Once the blisters healed Have, the contagious phase is finished. postherpetic neuralgia Some Individuals Develop a long-lasting postherpetic neuralgia pain condition called after an episode of shingles Having. Postherpetic neuralgia is more common in older persons. Early treatment of shingles With an antiviral medication postherpetic neuralgia May Prevent help. FOR MORE INFORMATION • Centers for Disease Control and Prevention
http://www. cdc. gov • World Health Organization http://www. who. int • American Academy of Dermatology http://www. aad. org Sources: Centers for Disease Control and Prevention, World Health Organization, American Academy of Dermatology, National Institute of Neurological Disorders and Stroke, National Institute of Allergy and Infectious Diseases
Climatic conditions favor the spread of some diseases. This week we’ll talk about herpes zoster, shingles or belt of San Andrés, an acute, self-limited infectious disease, which explained the dermatologist Raquel Rodriguez, is produced by reactivation of the chickenpox virus (infection that usually occurs in children “) . “After the chickenpox virus overcomes this becomes lodged in paraspinal ganglia neurological indefinitely without causing discomfort but later can cause herpes zoster,” said the specialist. Rodriguez said that this condition affects all races and is more common in men, usually in adults aged 30 years in the elderly or in patients immunocompromised (HIV, cancer, amounts of glucocorticoids, in diabetics, those receiving radiation ). clinical picture Dr. Rodriguez says the clinical picture is fast, “appear pain in a specific part of the body, in the affected areas of the nerves, accompanied with itching or burning, two or four days after appearing lesions on the skin as a stain pink or erythematous on which 12 or 24 hours vesicles which are grouped as clusters of grapes and are following the path of the affected nerve then do, then pustules or blisters that can break (or not) and can cause skin necrosis or bedsores. ” In addition, the specialist said that an important feature is that injuries never exceed half of the body, that is only affecting one side. In addition, there may be swollen glands and as almost always occurs in older people may be a lack of strength, headaches and some even fever. “When lesions disappear will leave white or dark spots, including scars; The entire process takes two to three weeks, it has once but there are some cases where repeated only with patients with immune disorders, “he said. As for where injuries occur, Dr. Rodriguez said there are specific areas most often: thoracic area, cranial region, lumbar and sacral.
complications There are several complications depending on the places that affects, for example, if it affects the facial nerve can cause eye complications ranging from keratitis even loss of vision. If it affects the auditory nerve can cause nausea, vomiting, dizziness and even deafness. It can also lead to post-herpetic neuropathy or post-herpetic neuralgia that occurs in the elderly who were not treated on time within 72 hours. It is vital to treat in this period with cortisone, because if the pain is acute, severe, persistent, exhausting, so that the patient does not think of anything else, besides the absence of medication discomfort may persist for six months or even years after the attack. Treatment When it affects children and young people do not require treatment, but if an adult patient is extremely important that physical activity decreases or stays resting in bed. Can be used faumentos Domeboro based calcium acetate and aluminum sulphate, cold faumentos water chamomile, glucocorticoids within 72 hours of injury, antivirals, antibiotics if added infections and appropriate references to specialists dependence of the affected region. Significantly, the doctor said the pain is so intense that it can be confused with angina, biliary or renal colic, also with appendicitis, duodenal ulcer and even glaucoma in the acute stage. Remember to send questions or suggestions for topics to lsevilla@elnuevodiario. com. ni NOTE
Dr. Raquel Rodriguez attends the “Bocona Stone”, Granada Clinic. Phone: 8887-9226.
INTRODUCTION The International Society for the Study of Pain defines neuropathic pain as “pain initiated or caused by a primary lesion or dysfunction of the nervous system due to alterations of central or peripheral nervous”. This disorder can be produced by compression, transection, infiltration, ischemia or metabolic injury to neuronal cells or a combination of these factors It is estimated that about 1-1. 5% of the general population suffers from some form of neuropathic pain, although some authors suggest that this effect may be even higher as pain present in some diseases such as cancer, degenerative or neurological diseases may have some neuropathic component. As the presence of neuropathic pain is greater in older patients and in general, the general population is aging, it is inevitable that neuropathic pain is a growing problem in health systems. Although there have been for centuries research on pain, neuropathic pain as such only gets an identity since 1994, when it was defined by the International Society for the Study of Pain (International Association for the Study of Pain- IASP) as “a pain that starts or caused by a primary lesion or dysfunction in the nervous system. ” This definition involves the concept that when an injury occurs in a nerve, changes in nerve pathways cause chronic pain occurs in the absence of a continuous stimulus. Thus neuropathic pain completely differs from nociceptive pain since this results from activation of sensory axons by painful stimuli that usually finite localized and disappear when the causes are eliminated. CLASSIFICATION The traditional classification of neuropathic pain is based on the underlying pathology (p. Eg. Diabetic neuropathy, trigeminal neuralgia, post-herpetic neuralgia, pain caused by spinal injury, etc.
) as well as in the location of the suspected nerve injury (peripheral or central). INTENSITY Although the extent of pain is a very subjective measure, scientists have developed several tools to evaluate it. The best known is the “visual analogue scale” call is used in patients over nine years able to use numbers to express the pain. On this scale, 0 expresses the absence of pain and 10 excruciating pain that requires immediate intervention. For children there is a graphic scale using the face of a puppet for the child to indicate which believes that best fits the pain. Other methods used by researchers pain for patients who can not use the above scales are the use of forms that take into account a number of symptoms (facial expressions, postures, etc. ) expressing pain. The best known are the comfort scale, the scale of crying, FLACC scale and the scale of nonverbal indicators. Another method widely used in clinical studies is the pain questionnaire McGill (McGill Pain Questionnaire). However, these methods have some important limitations, including the fact that the descriptors used for the description of pain do not conform exactly to neuropathic pain. The first scale designed specifically to measure Neuropathic pain Neuropathic Pain Scale (NPS) developed in 1997 by BS Galer and Jensen MP and amended in 2002 on the pain scale LANSS DIAGNOSIS
The separation stimulation symptom is one of the reasons why it is difficult to diagnose neuropathic pain. To be strict definition, the doctor should prove the existence of an injury or nerve dysfunction to diagnose neuropathic pain. For this reason, the diagnosis of neuropathic pain should take into account the complete medical history of the patient with an exhaustive clinical and neurological examination. The medical history will determine the start, the location and distribution of pain and possible association thereof to a trauma. Moreover, the description of pain (stinging, burning, diffuse, etc. ) as well as the examination of the affected areas to identify possible sensory deficits by some instruments (cold or hot to determine the thermal sensitivity rollers, brush camel hair for tenderness or a sharp object to determine sensitivity to pain) will determine an injury or nerve dysfunction
Shingles is a common and painful disease. Virtually all adults (> 95%) are at risk () and about 1 in 4 people will suffer an episode of herpes zoster at some point in their life () (). Shingles develops from the reactivation of varicella-zoster virus, acquired during an episode of chickenpox infection occurred in childhood and remains dormant in the body for life (). 95% of adults have had this common disease, usually as children, and for this reason most adults are at risk for herpes zoster (). As we age, especially after age 50 () (), the immune system weakens and increases the risk of developing shingles (). Symptoms and complications: shingles is often presented in the form of rash (rash) unilateral, but patients typically experience pain (). Shingles pain can be intermittent or continuous and appear daily or occasionally (). Most patients experience different sensations states among which are: burning, stinging sensation and dull pain (). The pain that occurs in the acute phase can last up to 30 days () before recovery. However, the shingles may also lead to serious complications including neuropathic pain long term, also called post-herpetic neuralgia () (). A distressing feature of long-term neuropathic pain is that it can occur even with a slight contact (). Also, shingles can cause eye complications such as decrease or loss of vision in cases of herpes zoster ophthalmic location () (). The treatment of herpes zoster is a major challenge and is insufficient () () () ().
When the pain is long-term, it is difficult to treat (). Shingles can cause significant impact to daily life () (): work, leisure activities, mental tasks and enjoyment of life (). [Total: 2 Average: 5/5] \x26amp; NbspPublicación: September 23, 2013 Last update: February 24, 2016
ALGEMEEN Herpes zoster is een zeer Pijnlijke, plotseling optredende huidreactie that gepaard gaat met kleine blaasjes. Het wordt door een veroorzaakt reactivatie van het waterpokkenvirus. Herpes zoster geneest spontaan in principe. Meestal kan been volstaan met pijnbestrijding en indrogende therapy voor de blaasjes. started Wanneer in de eerste 3 dagen van de aanval wordt met antiviral therapy verminderd been zal in de rule de duur van de aanval en ook de duur van de pijn. MEDICAMENTEUZE THERAPY: Lokaal met zinkpreparaat behandelen om te indroging accomplish. Systemic behandeling met valaciclovir is altijd bij geïndiceerd herpes zoster in het gelaat, herpes zoster oticus, gegeneraliseerde herpes zoster of bij verminderde weerstand. Bij prodromal pijn, long dan een week, of bij ouderen met matig dead ernstige pijn start met valaciclovir ter Preventie van postherpetic neuralgia within 72 uur na het ontstaan van de huidlaesies. Postherpetic Pijn behandeling: Algemene pijnstilling met paracetamol of NSAIDs Amitriptyline bij perifere neuropathy.
Bij been ernstige anticholinergic bijwerkingen kan naar uitgeweken nortriptyline Bij onvoldoende effect amitriptyline: eventueel carbamazepine toevoegen. Bij dysesthesia (neuritis): lidocaine of capsaicins over due. Zie ook hoofdstuk algemene pijnbestrijding PREPARATEN BIJ HERPES ZOSTER Zinc oxides smeersel FNA D: Meerdere paint aanbrengen per dag. B: – CI: – Tablet 500 mg (Zelitrex) D: 1,000 mg 3 dd gedurende 7 dagen, behandeling within 48 uur na verschijning huiduitslag start. B: Tablet may have to paint,.
CI: Voorzichtigheid is geboden bij nierfunctiestoornis. Postherpetic pijnbehandeling Tablet 10 mg, 25 mg, 50 mg D: Start met 10-25 mg 1 dd, geleidelijk verhogenmet 20 mg elke 3-5 dagen tot 50-75 mg per dag. Zo nodig verder verhogen tot max. 150 mg per dag. B: Tablet may have to paint,. CI: Long QT intervalsyndroom. Voorzichtigheid is geboden bij angina pectoris, hartfalen, leverfunctiestoornissen, porfyrie en prostaathypertrofie. Tablet 100 mg, 200 mg, tablet geregul. afgifte 200 mg, 400 mg stroop 20 mg / ml
(Tegretol) D: Aanvankelijk 200-400 mg per dag nodig geleidelijk in verdeelde doses, zo verghogen dead 200mg 3-4 dd, max 1200 mg per dag. Publishers tot zo laag mogelijke onderhoudsdosering. B: Retard tablet may have to paint, niet, gewone tablet wel. Alternatief: preparaat zonder gereguleerde afgifte, pas en keerdosering doseerinterval aan. CI: Porfyrie. Voorzichtigheid geboden bij leverfunctiestoornis s benign prostaathypertrofie. Pijnbestrijding lokaal Lidocaïnevaselinecreme 3% FNA Lidocaïne zalf D: Dun laagje op de laesie aanbrengen meerdere, painting per dag. B: – CI: –
cream (EMLA) D: Dun laagje op de laesie aanbrengen meerdere, painting per dag. B: – CI: – Cream 0. 025%, 0. 075% (Capsicum cream FNA) D: aanbrengen 3-4 dd. B: Niet op aanbrengen beschadigde huid- en slijmvliezen. CI: – Terug naar boven
The blisters break, forming small ulcers that begin to dry and form scabs, which fall into two to three weeks. Scarring is rare. The rash usually involves a narrow area of the spine around the front of the ventral region or chest. The rash may involve face, eyes, mouth and ears. Abdominal pain Fever and chills General ill feeling genital ulcers Headache Joint pain Swollen lymph nodes Also you may have pain, muscle weakness and a rash that involves different parts of the face if shingles affects a facial nerve. Symptoms may include:
Difficulty moving some of the muscles in the face Drooping eyelid (ptosis) Hearing loss Loss of eye movement Problems in the sense of taste Vision problems Other symptoms may include: In most people, skin patches are formed, followed by small blisters. Exams and Tests Your doctor can make the diagnosis by examining the skin and ask questions about your medical history. Rarely tests are needed, but these may include taking a skin sample to see if you are infected with the virus that causes shingles. Blood tests may show an increase in white blood cells and antibodies against chickenpox virus, but can not confirm that the rash is due to shingles. Causes After you get chickenpox, the virus remains inactive (dormant) in certain nerves. Shingles occurs when the virus reactivates in these nerves after many years.
Many people suffered so mild cases of chickenpox who are unaware of who had the infection. The reason why the virus suddenly becomes active again is not clear. Often only one attack occurs. Shingles can occur in any age group. more likely to develop the condition if you have: He has over 60 years of age. He gave chickenpox before the age of 1 year. Your immune system is weakened by medication or illness. If an adult or a child have direct contact with the rash shingles and chicken pox not give them children or did not receive the vaccine against this disease, they may have chickenpox, not shingles.
Shingles (herpes zoster) is a painful rash of the skin, caused by the varicella-zoster virus from the family of herpes viruses. (At initial contact the varicella zoster virus varicella. Causes) The virus can survive for decades in the nervous system and is therefore responsible for recurrences. Shingles is for people not practically contagious and affects only those which are not anticipated with the chicken pox in contact. (Very rare! ) The Shingles can affect all age groups, but is often diagnosed in elderly or immunocompromised people (for example, tumor patients or people with HIV). The first indication is a burning sensation. This arises in the region of Spinalnervenbahnen. The spinal nerves supplying the skin and form a spine of the forwardly extending semicircle. The pain is almost always on one side. Despite the impressive symptomatology the skin has not changed at this stage. By the slightest touch of the existing pain is amplified, is tolerated while slightly firmer touch. Only after two to three days is the typical rash added: Small bubbles on a swollen and reddened underground.
The rash is limited to a certain range. (Spinalnervlich furnished segment. ) After three to five days, the rash often reaches its peak. The bubbles burst on, it creates small wounds that are gradually covered with scabs. After two to three weeks the scab falls off mostly. In addition to fever rash may occur and sometimes swollen lymph nodes. Not infrequently, the complaints after more than a week, so stay but z. T. consist months unchanged. Or it occur (recurrences) regularly relapses. Indication: Shingles It is a disease that is affecting very well with the ESB / APM and especially in recurrent disease the results are impressive.
When Ohrbefundung the whole affected by the herpes side is mostly blank Find as energetic. And therefore it makes sense to prescribe to a SAM on the other side of the body. Thus, the symptoms can be improved in the short term. Since this improvement unfortunately only lasts a very short time, the patient while resisting occurrence of pain even ice should – for not more than 30 seconds – apply and repeat this measure if necessary several times. The Ice packs can be wrapped in plastic wrap to prevent the possibly wound powder additionally used is not converted to slurry. The ESB / APM treatments should only be made daily. Experience shows that a void condition arose after about a working week of the initial energy wealth. Now the affected side of the body to be treated. Here, the massage fingers should not, but the flat hand used soft. Typically when touching the painful areas that triggered by the treated hand pain of cancellation to deletion will feel less intense. Indications: neuralgia following shingles (postherpetic neuralgia) After a strong shingles nerve pain may remain (postherpetic neuralgia). Solche nerve pain may persist for months to years and are usually treated with the strongest painkillers, sometimes in combination antidepressants.
This nerve pain can be so severe that they are perceived like a knife. This is also a very suitable for the ESB / APM indication. Difficulties may make the resulting scar in treatment from the Efflorenzen (rashes), because these are not often more visible than scars. However, they reveal themselves through the characteristic scars ear zones. Indications: Recurrent Shingles Some patients complain about the regular in quite often, usually at the usual place occurring herpes zoster. Previous experiences have shown that these diseases are well beeinflussbar with the ESB / APM. is treated according to the ear findings. In most cases these are phenomena which are not indicated in patients as a treatment target, and therefore the results obtained are found almost as a “by-product”.
Herpes zoster, is a viral disease that generally can occur in anyone. Often it starts with a slight fever, fatigue and pain in a limited area of the skin. Only then they develop in the hip area. belly or lower back a liquid filled pustules. Herpes zoster name refers to these pustules, which extend generally in one hand like a belt around the body. The pustules appear on the face. The torso is the one that most often is affected by shingles. Shingles occurs most often in older people, in people over 60 years, the risk of getting a Herpes Zoster is particularly high. At first I was chickenpox . . . . Typically, chickenpox is a harmless childhood disease, which most are not nearly recalls.
However, since then it carries within it the chicken pox virus, which lies in the nerve ganglia cells or nerve pathways of the face. Perhaps lately suffered a strong stress, he was exposed during the holidays very touched face strong sunlight or was very touched on health. These factors can weaken their endogenous defenses, thus, the varicella virus gets a second chance to “declare” and multiply. So the chickenpox virus (varicella zoster virus) has caused a belt herpes or Herpes Zoster located at face level. The doctor calls it the disease herpes zoster, the virus lies in certain nerve ganglia supplying only the limited area of the skin. Therefore no eruptions throughout the body, as with chickenpox but, pustules are distributed in a limited area of skin on one side of the body or face. The virus travels from the nerve ganglia through the nerve to the skin, there to spread and multiply in the area of the skin which in the beginning was only enrojesida fibers. little by little they are arming small nodes that evolve to pustules filled with liquid. Neuralgia, are features . . . . Often, a few days before the first symptoms appear on the skin, you experience pain in the affected area.
This pain can be burning or stinging and skin escocida note. Because viruses spread and multiply at great speed, damage nerves, thus causing pain. For this reason it is important that the treatment is carried out quickly and follow to the letter, follow exactly as prescribed by your doctor, you have the drugs that relieve their pain and can stop the multiplication of the virus. After about three weeks. pustules dry up, scabs form and cured. Even Cured Herpes Zoster pain can persist. This risk increases with age, for this reason should seek medical advice, experience indicates that early treatment of shingles can reduce the likelihood of persistent pain (neuralgia postzoster) We speak of a neuralgia postzoster when the pains continue more than four weeks after giving skin symptoms. The causes of these pains are the destruction of peripheral nerves and nerve ganglia by viruses. Complications of Herpes Zoster. Like other illnesses, also the course of Herpes Zoster may present complications. Eye infection (Zoster Ophtalmicus) When shingles occurs on the face, possibly affecting the overall eye mind only one.
An eye infection may present with pain, dizziness, watery eyes, sensitivity to light and conjunctivitis, cornea and iris can be affected. Ear Infection (Zoster Oticus) Ear Infection with varicella zoster virus can go tarnished a unilateral facial paralysis. Discomfort features include tinnitus, deafness, sensitivity to noise and dizziness, in case of infection of the skin or eye antiviral drugs can remedy. Remember to visit your doctor, do not medicate at home. The physician should assist a Dermatologist (a)
Lopez Ocampo Paris Samahel Stephany Ochoa Montoya Guadalupe Herpes zoster infectious, viral, acute and localized disease that causes painful skin rash ampular HERPES ZOSTER It is characterized by the appearance of vesicles grouped in an inflammatory plaque located in the path of a nerve skin General characteristics Varicella zoster virus etiologic agent direct Transmission usually unilateral Reservorio
Humans Carrier humans Contact with injuries of people with herpes zoster infection Hint Contact with contaminated objects recently with secretions from the vesicles Incubation Two to three months 14 to 16 days Transmisiblilidad 1-2 days before the rash until they appear scabs 5 day average susceptibility risk factor’s
history of varicella inmunodependencia age Risk groups over 60 years Children with chickenpox before the 1st year background Immunity Normally lifetime but is 1 to 5% of cases recur That% 1% have a 3rd incidence or more prodomico period Burning Intense pain Nerve Hiperesetesia
Skin rash VESICLES Ulcers (when the vesicles break) ooze Secan crusting The scabs fall to 2 or 3 weeks sintomatologia Fever Escaliofrios Discomfort Swollen lymph complications
posherpica neuralgia bacterial infections recurrence Dissemination Paralysis Blindness Ramsay Hunt syndrome Classification ophthalmic herpes Herpes body spine surrounding the chest to the breastbone differential diagnosis Acute pain episode
Muscle pathology bone or viscera below dermatome: Trauma neoplasia Inflammation Fracture Infection mononeuritis diabetica vertebral cardiac ischaemia Pleuritis By the skin lesions Impetigo excema herpeticum
Hand -foot syndrome -mouth pemphigoid Treatment Symptomatic treatment analgesics Y antihistamines acyclovir reduces the course of enferemedad prednisone reduces the risk of neuralgia posherpica EPIDEMIOLOGY CRITERIA
CLINICOS acute rash, painful papular vesicular affecting a root nerve territory with possible ny numerous vesicles outside the territory Laboratory criteria Isolation of V-Z virus in cultured cell lines Nucleic acid detection V-Z virus Viral antigen detection Classification of cases Suspect case not applicable probable case Meets the clinical criteria Confirmed case Meets clinical and laboratory criteria
Notification ANNUAL NOTIFICATION AGE SEX VACCINATION RENAVE CNE CONTROL MEASURES AND IMMEDIATE CONSEQUENTIAL PROMOTION SPECIFIC PROTECTION Herpes zoster vaccine under 60 years
Herpes é uma doença identificada, na maior parte the vezes, pelas vesículas que nos aparecem lábios e que pessoas algumas chamam inadequadamente de febre intestinal. Essa lesão caracteriza o herpes simples que pode também os acometer genitais. No herpes zoster, popular elements conhecido como “cobreiro” as pequenas vesículas que se formam na pele acompanham o trajeto the raízes nervosas (imagem 1) numa faixa que pega semper to lado só do corpo. Causada pelo vírus since catapora, a fez enfermidade a fama de muitos benzedores que passavam to traço dividindo o corpo da pessoa infectada em duas Metades e preconizavam – “Daqui não vai passar”. E nunca mesmo Passava, porque a doença afetava apenas o nervo que vinha pelo lado direito, por exemplo. Do lado oposto, o nervo era outro, vinha since esquerda e não estava comprometido. AGENTE ETIOLÓGICO Drauzio – Qual é o agente etiológico, isto é, o germe responsável pela doença herpes zoster? Esper Kallas – O agente causador do herpes zóster é um vírus chamado Varicela zoster e que não deve ser confundido com o vírus do herpes simples que causa lesões na boca e nos genitais. O Varicela zoster é o agente de duas doenças: since catapora e do herpes zoster. A catapora, ou varicela, é transmitida de pessoa para pessoa, acomete principalmente crianças em idade escolar e provoca lesões no corpo todo, braços, pernas, rosto, tronco e às vezes, até dentro da boca (imagem 2). São lesões em forma de vesícula, isto é, pequenas bolhas cheias de líquido, cercadas por uma área de avermelhada característica inflamação. Depois, essas bolinhas d’água criam Cascas chamadas crostas (imagem 4) que secam e caem, deixando uma pequena cicatriz que Desaparece com o tempo.
Na esmagadora maioria dos casos, a doença evolui para cura ESPONTANEA. Embora seja incomum, a varicela pode ocorrer em pessoas de mais idade, como é o caso da senhora que aparece na imagem. 3 O herpes zóster é outro tipo de doença causada pelo mesmo vírus que fica num incubado nervo depois que provocou catapora. Cerca de 20% the pessoas podem ter herpes zóster em algum momento da vida. CARACTERÍSTICAS THE LESÕES Drauzio – cross dizer que o vírus since varicela, que por anos persiste, pode reaparecer sob nova apresentação? Esper Kallas – Embora seja causado pelo mesmo vírus que a varicela, o herpes zóster não é transmitido de pessoa para pessoa por via respiratoria. O vírus fica incubado no nervo e, por que não alguma razão conhecemos ainda, caminha por ele e provoca lesões parecidas com as there catapora. A imagem mostra 5 as vesículas num nervo que saiu since coluna e foi até a metade do corpo e a imagem 6, as lesões localizadas entre o Torax e o Abdomen do paciente. O herpes zóster pode causar lesões discretas ou mais numerosas. Nesse caso, as bolhas se misturam umas com as outras formando o que se chama de Confluencia. Na imagem 7, pode-se ver uma lesão que acompanha o nervo que vai para o braço e chega quase até o punho.
Drauzio – Como seguem a raiz nervosa, essas lesões podem aparecer em qualquer lugar do corpo, mas semper em apenas dos lados to . . . Esper Kallas – Uma the principais características do herpes zóster ou cobreiro é que a lesão não ultrapassa a metade do corpo, ou seja, a linha média que divide o corpo em duas partes: o lado direito e a lado esquerdo. Drauzio – Quando o herpes zóster acomete a face (imagem 8), quais as características mais importantes e as complicações corn Frequentes? Esper Kallas – O herpes zóster pode caminhar pelo que vai para nervo a face. Em regiões como o ou Torax a perna, a conduta seria que esperar as feridas desaparecessem depois de sete dias. Na face, a situação é diferente. Ele pode acometer os que nervous vão para o olho a causar ceratite, uma inflamação since córnea (membrana transparent que recobre o olho), o que pode causar problemas de visão. Herpes zóster na região da face, além do tratamento convencional, Requer cuidados especiais também do oftalmologista. Sintomas e Transmissão DA doença Drauzio – Quais são os principais sintomas do herpes zoster? Esper Kallas – Os primeiros sintomas são um pouco de formigamento e dor no lugar onde vão aparecer as lesões e, em alguns casos, febre baixa no primeiro dia.
Depois, começa a aparecer vermelhidão no local afetado e só então eclodem as bolinhas com água, ou seja, as vesículas Contendo o vírus. Drauzio – Quantos dias leva entre o aparecimento the Primeiras alterações de sensibilidade e o aparecimento the lesões? Esper Kallas – De to a dois dias. Uma vez instaladas as lesões, se a pessoa gozar de boa saúde em sete dias mais ou menos todas Terao criado crosta e a doença praticamente terá chegado ao fim. Como no herpes zóster a lesão é localizada, não há Transmissão respiratoria, mas a doença pode ser transmitida através do contato, porque o vírus está dentro ativo the lesões vesiculares. Portanto, quem tem criança vivendo na mesma casa não precisa ter medo de transmitir o vírus apenas por conviver no mesmo ambiente com a pessoa infectada. Drauzio – cross dizer que o vírus incubado corre por dentro do nervo, chega até a pele e está presente nas vesículas que se formaram? Esper Kallas – Está presente. Alias, essa capacidade de correr pelo nervo pode causar inflamação intensa e dor muito forte nesse local. Essa é outra característica do herpes zoster. Drauzio – Que cuidados a pessoa com lesões herpéticas deve tomar em relação aos contatuantes? Esper Kallas – O mais importante é tomar cuidado com a Manipulação ferida since. A pessoa deve lavar as mãos com água e sabão antes e depois de lidar com a lesão e, se por acaso notary que as bolinhas estão estourando, deve cobrir a região para não deixar que o líquido Contendo vírus vaze, o que facilitaria a contaminação de outras pessoas.
Drauzio – Nesse caso, separar toalhas e objetos que pessoais entram em contato com a lesão é muito importante. Esper Kallas – É importante. Além disso, outra medida que se aconselha é como usar substâncias agua para boricada impedir que se bacterias alojem sobre as bolinhas e causem infecção. nevralgia Drauzio – Como é a dor característica do herpes zoster? Esper Kallas – Como o herpes zóster caminha por um nervo responsável pelas Sensações da região onde se situational, sua inflamação pode provocar uma dor intensa chamada nevralgia exatamente no local em que a lesão apareceu. Em crianças e jovens, a dor pode ser mais ou até fraca nonexistent. O problema é quando ela acomete pessoas de idade corn avançada, porque a inflamação do nervo pode ser de tal magnitude que provoca uma nevralgia que persiste por muito tempo – em média mais de cem dias – e exige a prescrição de Remedios potent para tirar a dor , Ha, ainda to porcentual pequeno de pessoas que manifesta dor permanent depois da crise de herpes. Em termos de tratamento, a primeira coisa a fazer para controlar a dor é represents Remédios contra o herpes zóster o mais cedo possível. A segunda é tratar as pessoas que apresentam nevralgia por tempo prolongado com medicamentos para esse tipo de dor específico causado pela inflamação do nervo. Herpes zoster E AIDS Drauzio – Fale to pouquinho sobre a relação entre herpes zóster e imunodepressão, especificamente a dos pacientes com AIDS que apresentam herpes zoster. Esper Kallas – O herpes zóster só se manifesta em aproximadamente 20% the pessoas durante a vida e não inteira sabemos exatamente por que isso acontece.
Aparentemente, existe entre o Equilíbrio vírus que fica incubado e o sistema de defesa do organismo, o sistema imune. Se essa defesa baixa um pouco, o tem vírus facilitadas as condições para o causar cobreiro. Pessoas com sistema imune muito mais rebaixado estão predispostas a manifestar herpes zoster. Portadores de HIV com deficiencia do sistema imune instalada, indivíduos com alguns tipos de câncer ou que tomam Remédios imunodepressores estão corn sujeitos ao aparecimento since doença que pode ter duração prolongada e às vezes, extrapolar a região do nervo e distribuir-se por outras áreas do corpo. Nesse caso, a doença não está mais localizada, Requer cuidados redobrados e muito mais tratamento agressivo. Drauzio – Os casos em que a doença se dissemina pelo corpo, embora muito graves, são raros e, para que se instalem, o sistema imunológico precisa estar muito debilitado. Esper Kallas – É verdade. E, porque são muito graves, requerem cuidados especiais. Por exemplo: os antivirais precisam ser ministrados por via intravenosa para se ter certeza de que a quantidade de medicamento é suficiente para conter o avanço since doença. PRENÚNCIO DE outras doenças Drauzio – Vamos pensar na pessoa normal que de repente começa a sentir uma Sensação Esquisita to pouco de dor e dois dias depois vê eclodir as lesões do herpes zóster sem que nenhuma enfermidade de base justifique esse aparecimento. Alguns médicos defendem que esses casos precisam ser investigados, porque podem ser sinal de uma infecção oportunista denunciando a presença de que alguma coisa mais grave está ocorrendo no organismo. Há justificativa científica para essa conduta?
Esper Kallas – Por muitas Decadas, a classe médica esteve preocupada com esse problema e foram Feitos vários trabalhos envolvendo centenas de pessoas com herpes zóster para verificar se sua presença era sinal de doenças como a deficiencia imunológica ou algum tipo de câncer, por exemplo. No entanto, como todas essas Pesquisas não foram capazes de estabelecer relação entre o herpes zoster e o prenúncio de doenças corn graves, a investigação foi abandonada. Assim, pessoas com herpes zóster não ficar precisam preocupadas com a possibilidade de estarem imunologicamente deprimidas, exceto se outros sintomas, além do herpes zoster, sugerirem a presença de doenças corn graves. Drauzio – Nós já que são mais mencionamos susceptíveis de apresentar herpes zóster as pessoas com AIDS ou que fazendo tratamentos debilitam muito a imunidade. Diabéticos também estão corn sujeitos a desenvolver a doença? Esper Kallas – Não. Sabe-se que a principal causa do herpes zóster é a Depressão imune, mas não se conseguiu estabelecer correlação entre seu aparecimento corn frequente e outras enfermidades. USO DE ANTIVIRAIS Drauzio – Hoje, existem antivirais potent para o tratamento do herpes zoster. Quando Devem ser prescritos? Esper Kallas – O herpes zóster tem uma história de resolução natural. Mesmo que nada seja feito, provavelmente em sete dias a pessoa estará Curada. A grande vantagem do tratamento precoce está em diminuir a possibilidade de instalação since nevralgia because dor intensa, especialmente nas pessoas acima de 40 anos.
Portanto, assim que se nota o aparecimento the Primeiras vesículas, o é indicado introduzir a medicação, na maior parte the vezes por via oral. Hoje, existem vários medicamentos diferentes que essa cumprem função. O primeiro a aparecer foi o aciclovir que pode ser tomado na forma de comprimidos. O único inconveniente desse remédio é que precisa ser tomado de quatro em quatro horas, enquanto outros antivirais podem ser tomados duas ou três vezes por dia apenas. Isso facilita a adesão ao tratamento que deve ser mantido pelo período de cinco dias curto. Drauzio – Alguns casos exigem tratamento corn prolongado? Esper Kallas – Exigem tratamento persistent um pouco mais prolongado as pessoas com sistema imune muito debilitado ou com herpes zóster corn agressivo e. Drauzio – Você disse que os primeiros sintomas são formigamento e dor. Depois aparecem as vesículas com líquido em seu interior, que uma criam crosta e caem encerrando o episódio de herpes -zóster. Você disse que também o tratamento deve ser o mais instituído rapidamente possível. Há momentos em que não mais Adianta tratar? Esper Kallas – Quando as vesículas já criaram casquinhas, ou crostas, é que o sinal de vírus não está mais lá e que o sistema de defesa deu conta de debelar a infecção. Nesse caso, não vale a pena mais tratar, porque já se perdeu a oportunidade de aproveitar os Benefícios do uso do antiviral.
Drauzio – Depois que se as crostas formaram, o vírus saiu da pele, mas não desapareceu do organismo. Ele volta para dentro da raiz nervosa e as células de defesa e os anticorpos não conseguem atingi-lo. Isso indica que o herpes zóster pode recidivar? Esper Kallas – Pode, mas é muito incomum. As recidivas só ocorrem em aproximadamente 4% the pessoas que gozam de boas condições de saúde. Portanto, quem já teve to episódio de herpes zóster dificilmente terá outro. Vacinas Drauzio – Existe vacina contra o vírus Varicela-zóster? Esper Kallas – Existe uma vacina contra esse vírus usada na Prevenção since catapora em crianças. Mini Strada em dose única a partir de um ano de idade, de garante 90% a 100% de proteção, segundo todos os estudos realizados. No Brasil, ela já consta do sistema de gratuito vacinação. É possível que essa vacina também Previna Episodios de herpes zoster. No entanto, valley hipótese demanda tempo para ser comprovada, uma vez que a vacina é relativamente recente.
Drauzio – Mas especificamente contra o herpes zóster existe vacina? Esper Kallas – No Brasil, desde abril de 2014 podemos contar com uma vacina em dose única específica contra o herpes zoster. Chama-se Zostavax e tem aprovação da Anvisa para ser mini strada a partir dos 50 anos, fase em que as pessoas apresentam maior risco de desenvolver a doença. Além de reduzir um pouco a possibilidade de reativação do vírus, essa vacina previne a incidencia since nevralgia pós-herpetic e seus quadros dolorosos. Drauzio – Vale a pena vacinar contra catapora pessoas que fazer vão tratamento agressivo contra o ou câncer transplante de órgãos? Esper Kallas – O primeiro passo é saber se a pessoa ou não teve varicela ou catapora. Se teve, não Adianta vacinar, porque já entrou em contato com o vírus. Caso contrario vale a pena fazer a vacina. A vacinação também é indicada para crianças com Certos tipos de leucemia e de linfomas e que não entraram na faixa etária de maior exposição ao vírus Varicela zoster. Para as pessoas mais de idade, como o vírus é muito comum e facilmente transmissível, a maioria já entrou em contato com ele e a vacina contra catapora não hoopla benefício algum. * Entrevista revista e atualizada em junho de, 2015. Publicado em 03/02/2012
TCM considers the Herpes Zoster a latent infectious factor that emerges after an attack by a pathogenic factor and insufficient Zheng Qi caused by a stagnation of Qi can evolve Fire Liver and Gallbladder, or moisture retention Spleen , Heat-Moisture accumulation inside, or invasion of Pathogenic Factors. Fire syndrome that affects the Liver and Gallbladder, we find that there internally Fire by stagnation in the liver meridian and externally exogenous fire that attacks and Jueyin Shaoyang meridians. The symptoms we found are injuries fiery red and skin with burning and heat, dry mouth with a bitter taste, constipation, yellow urine, irritability, red tongue with a yellow coat and a pulse string and fast. Spleen syndrome, Heat-Humidity found internally and externally Fire Exogenous. In this case the symptoms of heat are presented with fluid-filled blisters thick, yellowish easily broken, poor appetite, abdominal distension, the body pale tongue with a sticky layer of white or yellow, and a rapid pulse and slippery. Therapeutic Principle to fight Herpes Zoster is Removing Fire and toxins, eliminating Damp-Heat and promote diuresis. The treatment to be performed with moxibustion involves burning moxa five small cones at each point, first cleaning the skin with oil to prevent burns. A cone is lit when the former has been turned off because the patient has felt the sensation of heat. Moxa cones burn at three points, to 0. 5 cm away from the head of the serpent, in the center of the serpent (area without injury) and 0. 5 cm of the tail of the snake (latest injury). Fire Syndrome in Liver add H2-Xingjian in Syndrome Spleen Damp-Heat in E44-Neiting and B6-Sanyinjiao, and if Stagnation of Qi and Xue V17-Geshu added. With this treatment symbolically we kill the snake by cutting off the head, body and tail.
Moxibustion is a technique that involves the application of heat in certain acupuncture points or body areas by burning or pure cones made from the plant Artemisia vulgaris. Its main applications are three: Heat and disperse the cold, both internal and external; activate the circulation of Qi and Xue in the meridians and strengthening the Zheng Qi. In the case of Herpes Zoster moxibustion acts effectively activating the circulation of Qi and Xue meridians and strengthening the Zheng Qi. We know that the main cause of Herpes is Qi stagnation leading to Liver-Fire and accumulation of Damp-Heat in Spleen. It is also shown that moxibustion improves the immune system, since its application favors the increase in the number of lymphocytes, immune mediators and neurotransmitters.
Herpes é uma identified doença, na maior das vezes part, vesicles pelas that we aparecem lips and that algumas pessoas chamam inadequadamente of intestinal febre. Essa characterized lesão or herpes simplex that you genitais também pode undertake. No herpes zoster, conhecido popularly as “Cobreiro” as small vesicles that formam na pele acompanham or trajeto raízes das nervosa (imagem 1) numa semper um faixa sticking side só corpo do. Vírus caused hair gives catapora, a fez enfermidade to fame benzedores muitos that passavam um corpo da traço dividindo or infected pessoa em duas Metades and preconizavam – “Daqui não vai passar”. I never passava mesmo, because afetava doença Nervo just that vinha hair or direito side, exemplo. Do oposto side or Nervo was outro, vinha da esquerda e não estava committed. Etiologic Agent Drauzio – Qual é or etiological agent, isto é, or germe responsable doença herpes zoster peels? Esper Kallas – O causative agent do herpes zoster é um vírus chamado Varicella-Zoster and that não deve be confused com or viruses do cause herpes simplex to lesões na mouth and genitais us. Varicella-zoster O é or agent doenças duas: da catapora and do herpes zoster. A catapora, ou chickenpox, é for pessoa pessoa transmitted mainly rushing em crianças school idade and causes lesões corpo not all, braços, pernas, rosto, trunk and, às vezes, tied in da mouth (imagem 2). Lesões em São form of vesicle, isto é, bolhas small cheias liquid, surrounded by uma feature inflamação avermelhada area. Depois, Essas bolinhas d’Agua CRIAM cascas crusts chamadas (imagem 4) secam and caem, deixando small scar disappears com uma or tempo.
Na esmagadora maioria two cases, evolui doença to spontaneous cure. Seja embora incomum, varicella or riding pode mais pessoas em idade, such as é or case appears senhora da na imagem 3. Or herpes zoster outro é mesmo type of hair doença virus caused fica num incubated nervo depois that provocou catapora. About 20% das pessoas podem herpes zoster ter em algum gives life time. FEATURES DAS LESÕES Drauzio – Quer dizer that gives chickenpox or virus that persists for years, prune reappear sob apresentação nova? Esper Kallas – Embora seja hair caused mesmo varicella virus or herpes zoster não é to pessoa pessoa transmitted by AIRWAY. FICA or viruses not nervo and incubated for alguma conhecemos ainda não razão that, caminha by ele and causes similar lesões com as da catapora. A imagem mostra in May as num nervo vesicles that saiu gives coluna and foi tied to metade do corpo e a imagem 6 as lesões located between or chest, or abdomen and do patient. Or herpes zoster pode cause numerous discrete lesões ou mais. Nesse case, as bolhas umas ace outras com misturam that chama forming or confluent. Na imagem 7 pode-se uma lesão that acompanha or nervo that vai for or braço and chega quase até o punho see. Drauzio – As seguem to nervosa root, Essas lesões appear podem do corpo em qualquer place, but just um semper em both sides .
. . Esper Kallas – Uma das principais herpes zoster features do ou é Cobreiro that lesão ultrapassa to do metade corpo não, ou seja, to linha média dividing or corpo em duas parts: o direito and side to side esquerdo. Drauzio – Quando or herpes zoster Rushing face (imagem 8), mais quais as important characteristics and as frequent complicações mais? Esper Kallas – O herpes zoster prune hair caminhar nervo vai for a face. Em regiões or chest as perna ou to conduta would expect as feridas desaparecessem depois sete dias. Na face, a different situação é. Ele pode nervos that you undertake or olho vão to cause ceratite, uma inflamação gives cornea (transparent membrane that recovers or olho), or prune visão cause problems. Herpes zoster na região da face, além do conventional tratamento, requer especiais também do oftalmologista care. SYMPTOMS E TRANSMISSAO DA doença Drauzio – Quais são os principais herpes zoster symptoms do? Esper Kallas – Os Primeiros são um pouco symptoms of formigamento and not place onde dor vão lesões appear as e, em alguns cases, no primeiro baixa febre day. Depois, Começa to appear afetado nonlocal vermelhidão and só então eclodem bolinhas as com água, ou seja, as containg vesicles or viruses.
Drauzio – Quantos cam or aparecimento das days between alterações primeiras of sensibilidade and lesões or aparecimento das? Esper Kallas – De um to dois dias. Once installed as Uma lesões is to enjoy pessoa boa saúde, sete dias em mais ou menos Terao all raised crosta and to doença praticamente terá chegado ao fim. Herpes zoster as to lesão é localized, não há transmissão breathing, but to prune doença do contato be transmitted using, for either virus is vesicular ativo in das lesões. Portanto, quem tem criança vivendo na mesma house não ter medo transmit accurate or virus just by conviver no mesmo com a pessoa infected environment. Drauzio – Quer dizer or viruses that run inside incubated do nervo, chega tied to peel and present nas vesicles formaram? Esper Kallas – is present. Aliás, capacidade essa running nervo cause severe hair pode muito forte inflamação e dor Local nesse. Essa é outra do herpes zoster feature. Drauzio – That care pessoa com lesões deve herpetic take years contatuantes relação em? Esper Kallas – O mais é important to take care turned Manipulação gives preferred. A deve pessoa wash as mãos com água e sabão before e depois lidar com lesão e, perchance note that as bolinhas estão estourando, deve cobrir to região for não deixar that containg or liquid vaze vírus, or would facilitate contaminação of outras pessoas. Drauzio – Nesse case, separate toalhas and Pessoais objects entram em contato com é muito lesão important.
Esper Kallas – and important. Além disso, outra é aconselha as you use substances like boric acid water to prevent bacteria from alojem on bolinhas as e infecção causem. NEVRALGIA Drauzio – As feature é a dor do herpes zoster? Esper Kallas – As herpes zoster or caminha by responsável um nervo sensações pelas gives região onde is located, sua uma inflamação pode cause exatas nonlocal chamada nevralgia em dor intense that lesão apareceu. Em crianças e jovens, dor pode ser mais ou até fraca nonexistent. O problem é quando ela Rushing pessoas mais avançada idade, because inflamação do nervo pode be of such magnitude that causes uma nevralgia that persists for muito tempo – em média mais cem days – and requires prescrição of potent remedies to shoot dor . Ha, ainda, um small percentage of pessoas that manifest permanent dor depois da crise herpes. Em tratamento thermos, a primeira coisa a fazer to control dor é give remedies or herpes zoster or mais cedo possível. A second é try pessoas as that apresentam nevralgia by prolonged tempo com esse drugs for specific type of nervo pela dor caused inflamação do. HERPES Zoster E AIDS Drauzio – Fale um pouquinho on to relação between herpes zoster and imunodepressão, specifically two AIDS patients com that herpes zoster apresentam. Esper Kallas – O herpes zoster manifests só em about 20% during a inteira das pessoas e não life exatas isso know why it happens.
Apparently, there is balance or viruses that FICA and incubated defesa or do body system, or imune system. Baixa defesa is essa um pouco, or vírus tem condições provided as to cause or Cobreiro. Pessoas com imune system muito mais rebaixado estão predispostas to express herpes zoster. HIV carriers com deficiência do system imune installed, gizmos com alguns cancers ou that Tomam imunodepressores Remédios mais SUBJECTS estão year aparecimento gives doença that pode ter prolonged Duração and, vezes às, extrapolate região nervo do and distribution-is by outras areas corpo do. Nesse case to doença mais não is located, requer redobrados care e muito mais tratamento agressivo. Drauzio – Os cases that doença corpo em hair, serious muito embora, são rare and, for that instalem, or imunológico accurate system dissemina muito be weakened. Esper Kallas – É verdade. E, because I são muito serious, requerem especiais care. For exemplo: I antivirais precisam be ministered intravenously for certain that a drug Quantidade é enough to conter or avanço gives doença is ter. OUTRAS harbinger of DOENCAS Drauzio – We think na pessoa normal that Comeca suddenly feel uma esquisita sensação, um pouco dor e dois dias depois do vê eclodir lesões as herpes zoster nenhuma enfermidade sem esse justify aparecimento base. Alguns medical defendem that precisam esses cases be investigated, because podem be sinal de uma opportunistic infecção denouncing presença that alguma coisa mais grave is not ocorrendo body. Ha scientific justification for conduta essa?
Esper Kallas – By muitas decades, esteve medical classe worried com esse problem and foram feitos trabalhos vários envolvendo hundreds of pessoas com herpes zoster to verify it sua presença was sinal of doenças as imunológica deficiência ou algum cancer, by exemplo. No entanto, like all inquiries Essas não foram of relação able to cash estabelecer between herpes zoster or e o mais harbinger of serious doenças, foi abandoned to investigação. Assim, herpes zoster com pessoas não com precisam fy concerned estarem Possibilidade of immunologically depressed, exceto is outros symptoms, herpes zoster além do, sugerirem to presença mais serious doenças. Drauzio – Nós já são mais mentioned that apresentar susceptíveis of herpes zoster as pessoas ou com AIDS fazendo Tratamentos that debilitam muito to Immunity Challenge. Diabetics também mais SUBJECTS estão to unwrap doença? Esper Kallas – Não. Know-is that a major cause herpes zoster do é a imune Depressão, mas não estabelecer correlação is conseguiu between aparecimento frequente e outras mais seu deseases. USE OF ANTIVIRAIS Drauzio – Hoje, existem powerful antivirais for or herpes zoster tratamento do. Quando Devem be prescribed? Esper Kallas – O herpes zoster tem uma história natural resolução. Mesmo nothing seja feito, provavelmente em sete days a pessoa will be cured. A large do Vantagem tratamento it is precoce em diminuir to Possibilidade of instalação nevralgia da, da dor intense, especially nas pessoas acima de 40 anos.
Portanto, assim that note or give primeiras aparecimento vesicles, or indicated introduzir to medicação é, na maior part vezes das orally. Hoje several different medications existem cumprem essa função. O Primeiro to appear or acyclovir foi prune na be taken as tablets. Or only drawback remédio é desse that needs to be taken from quatro em four hours, outros enquanto antivirais podem be taken ou duas vezes just three a day. Isso ao facilitates adesão tratamento to be mantid hair deve curto period of five days. Drauzio – Alguns tratamento exigem mais prolonged cases? Esper Kallas – tratamento mais um pouco Exigem as long pessoas com muito imune system weakened herpes zoster ou com mais agressive and persistent. Drauzio – Você disse that you Primeiros são symptoms formigamento e dor. Depois aparecem as liquid vesicles com em seu interior, uma CRIAM crosta and caem encasing or herpes outbreak -zóster. Você também disse that or tratamento deve be instituted or mais possível quickly. Ha moments em que não mais adianta try? Esper Kallas – Quando as vesicles já criaram casquinhas, ou crusts, sinal é or virus that is não mais e than or defesa deu conta system of debelar to infecção. Nesse case, não mais worth to worth trying, because já is perdeu to oportunidade net profit of aproveitar do you do use antiviral.
Drauzio – Depois that is formaram as crusts, or vírus saiu da pele, mas não do desapareceu body. Ele volta for inside da nervosa and defense cells as root and you anticorpos não conseguem Atingi-lo. Isso indicates that herpes zoster or prune recur? Esper Kallas – Prune, é muito incomum more. As recurrences só em ocorrem about 4% das pessoas that gozam of saúde boas condições. Portanto, quem já teve um episode of herpes zoster hardly terá outro. Vacinas Drauzio – There vacina against or VZV? Esper Kallas – There vacina uma against vírus used esse na da catapora prevenção em crianças. Em ministered single dose from year to idade um, guarantor of 90% to 100% of proteção second estudos you all made. No Brasil, ela já system consists do Vaccination is free. Vacina ESSA É também possível Previna herpes zoster episodes. No entanto, such hipótese tempo claimed to be comprovada, uma vez that vacina relatively recente é.
Drauzio – More specifically against herpes zoster or vacina there? Esper Kallas – No Brazil, from April 2014, we can count em uma com vacina dose or only specific against herpes zoster. Chama-se tem Zostavax and aprovação da Anvisa to be ministered from two 50 years, phase as pessoas em maior apresentam Crag doença unwrap. Além of reduzir um pouco to Possibilidade of reativação do vírus, I warned vacina essa da nevralgia incidence pós-herpetic e seus quadros painful. Drauzio – Vale a pena vacinar against pessoas catapora that vão tratamento fazer ou agressivo against transplant or cancer Órgãos? Esper Kallas – O Primeiro passo é know is ou não teve to pessoa ou catapora chickenpox. It teve, não vacinar adianta because entrou já em contato com or viruses. Otherwise, vale a pena fazer to vacina. A Vaccination is indicated for também é com crianças certos leukemias and lymphomas and that não na entraram faixa etária of Varicella zoster exposição ao maior vírus. For ace pessoas mais idade as é muito or vírus Common and easily transmissível to maioria já em contato com ele entrou and to vacina against catapora não algum will show benefício. * Interview magazine and Atualizada em junho 2015. Published em 03/02/2012
HERPES ZOSTER The Herpes zoster (HZ) is also known as zone or shingles, occurs as a result of reactivation (worsening) endogenous chickenpox infection that persists in a latent form in the sensory ganglia. HZ affects patients with impaired immunity. This is a relatively rare disease among older people and usually benign, but has the potential of morbidity and mortality especially in immunocompromised hosts. HZ most commonly it affects the spinal nerves and cranial nerves. HZ is characterized by prodromal symptoms with blistering unilaterally on an erythematous base in a dermatomal pattern and involvement of trigeminal and facial nerve resulting in orofacial manifestations. If left untreated, it leads to deadness HZ teeth, osteonecrosis of alveolar bone, tooth exfoliation, James Ramsay Hunt syndrome and post-herpetic neuralgia (PHN). Varicella and HZ are usually diagnosed by the classic clinical presentation though atypical presentations can make diagnosis more difficult. Mankind has always been affected by some diseases tend to spread from one person to another, as well as the whole community. Among these diseases, the most common is of viral origin. The virus that causes primary and recurrent infections, skin and in the oral cavity are the group of herpes viruses. Herpes simplex and varicella zoster virus are the most common causative agents among the group of herpes virus. Chickenpox is infection resulting from direct exposure to the varicella-zoster virus.
HZ occurs as a result of the reactivation of endogenous infection. HZ is highly infectious, since an individual not immune primary chickenpox can develop after exposure to a patient with acute herpes zoster. HZ is characterized by prodromal symptoms such as fever, headache, burning pain, followed by an acute phase, with the appearance of unilateral vesicles on an erythematous base in a dermatomal pattern. The prodromal pain before vesicular eruptions can simulate pulpitis. Inside the mouth, HZ is characterized by the formation of vesicles and blisters are scattered and surrounded by an erythematous area, which soon becomes ulcerated and covered by a white pseudomembrane. In a patient with multiple devitalized teeth without local or odontogenic causes, HZ should be considered as one of the differential diagnoses. Therefore, HZ is of vital interest to a dentist because of its characteristic lesion and resembles prodromal symptoms of toothache. The early recognized individual HZ avoid unnecessary dental procedures and timely management can reduce subsequent complications of herpes zoster. Virus: a poisonous or viscous fluid Hippocrates described the Greek word “herpes”, which means “creep or crawl,” referring to the nature of disease spread herpes zoster. HZ was first described as an injury to the spinal ganglia by Friedrich Von Barensprung in the year 1861. In 1907 Hunt first described infection by HZ geniculate ganglion and named as James Ramsay Hunt Syndrome. Stermlicht HC in 1954, describes dental pain as a symptom of HZ.
Verbin et al in 1968 have reported a case with toothache (pulpitis) as an early sign or prodromal of HZ involving the division of the second and third branch of the trigeminal nerve. Hudson and Vickers in 1971 reported a case of HZ in pain, like a toothache, was a prodromal feature. Replication of virus varicella zoster occurs in the nucleus. After forming the virions in the perinuclear space, it merges with the outer face of the nuclear membrane and nucleocapsids are released into the cytoplasm. Transmission of the virus occurs either by inhalation, ingestion, skin or mucosal contact with blood and blood products and other biological fluids such as semen, milk and colostrum. The varicella zoster virus reactivation later stage HZ cause infection and can be reactivated by physical or emotional stress and decreases host resistance. The incubation period represents the time required for propagation of the virus from the entry site of viral multiplication organs and therefore the target organs for production of injury. The clinical features of HZ infection are characterized by latency in which clinical manifestations appear after prolonged periods of inactivity during which the virus remain hidden in the nerve root ganglia. Aging, immunosuppression (malignancies, infections, drugs), uncontrolled diabetes, renal transplantation, radiotherapy, surgery, spinal cord / local trauma and alcohol abuse can act as predisposing factors. The incidence of HZ is 5. 4% in the general population. Whites are more affected than blacks. It has no sex predilection, and occurs mainly in middle-aged and elderly, and most commonly affects the trunk of sensory nerve of the head and neck, C3, T5, L1 and L2 and the trigeminal nerve.
The prodromal phase is characterized by pain and paresthesia intense precede rash in 90% of cases, along the dermatome of the affected nerve. As the virus travels along the nerve, the pain intensifies and described as burning, itching, and afilante. Lesions occur outside the dermatome because viremia. Constitutional symptoms such as fever, malaise and headache are accompanied by one to four days before the onset of mucocutaneous lesions. The acute phase begins with the development of the group of vesicles on an erythematous base. Within 3-4 days, the vesicles become pustules and ulcerate and after 7-10 days rupturan with crusting. The lesions tend to follow the path of the affected nerve and end up in the midline. The lesions heal in 2-3 weeks, either with hypopigmentation or hyperpigmentation. About 15% of cases can proceed to the chronic phase (3 months after the acute infection), resulting in post-herpetic neuralgia (PHN). The period of resolution of pain varies from 2 months to 20 years. The pain is sometimes so severe that patients have attempted suicide. Occasionally there may be severe pain of abrupt onset and constitutional symptoms hiperestesia without blistering of the skin and mucosa called as Zoster Sine Herpete. When the geniculate ganglion of the facial nerve is infected, the characteristic signs include unilateral vesicles of the outer ear and oral mucosa, and unilateral facial paralysis known as Ramsay Hunt syndrome.
Participation of C2 and C3 by HZ causes lesions on the back of the scalp, neck, part of the ear, part of the lower jaw and the front of the neck. The involvement of the upper or mandibular divisions of the trigeminal nerve can cause damage to the oral mucosa or skin or both. In some cases, the three divisions of the trigeminal nerve may be involved on one side or both sides. Skin lesions usually precede intraoral lesions, although some cases may start with paresthesia of the mental nerve. Intraoral, scattered and surrounded by an erythematous area vesicles soon become ulcers and covered by a white pseudomembrane. The most common intraoral sites are the anterior portion of the tongue, soft palate, and cheek. When it comes to the maxillary division lesions are located in areas that include the cheek, lower eyelid, side of the nose, upper eyelids and the mucous membrane of the nose, nasopharynx, tonsils and the roof of the mouth. Pain can simulate a severe toothache and lead to unnecessary oral surgery or dental treatment. HZ mandibular division involves the side of the head, part of the outer ear and ear canal, lower lip and part of the lining of the mouth. Participation of sensory ganglia components glosofaríngeo involves the development of pain and blisters in the ear, the soft palate, uvula, tonsils, pharynx, epiglottis and adjacent posterolateral surface of the tongue. Healing occurs in 2 to 3 weeks with an excellent prognosis. Complications HZ includes NPH, facial paralysis, vascular disease, peripheral weakness motor / segmental myelitis, ophthalmic herpes, herpes zoster oticus, syndrome acute retinal necrosis, hepatitis / pneumonitis, skin diffusion, generalized infections involving visceral organs , encephalitis or meningoencephalitis. Complications include osteonecrosis dental alveolar bone, tooth spontaneous exfoliation, devitalization of the teeth, the internal root resorption and periodontitis.
Diagnosis is difficult during the prodromal period, when pain is present, without injuries. During this stage the differential diagnosis of severe prodromal pain should include dental pulpitis. When the clinical appearance is typical and the vesicles are present, oral HZ can be distinguished clinically from other multiple acute lesions of the mouth that are bilateral and not along the path of the nerve. The various syndromes associated with HZ are Syndrome James Ramsay Hunt syndrome, crocodile tears (defective regeneration of facial nerve fibers during recovery can result in profuse tearing during mastication), congenital varicella syndrome, progressive retinal necrosis syndrome external (PNRE), Guillain-Barre syndrome. The various investigative procedures are complete blood count may show elevated white blood cells, a nonspecific sign of infection. If Pap smear sample Tzanck intranuclear inclusion bodies with multinucleated giant cells, syncytia and degeneration of the nuclei balloon. The biopsy shows Acantholysis with formation of numerous free-floating cells and degeneration Tzanck balloon. Nuclear fragmentation occurs with chromatin condensation around the core periphery. Virological tests such as isolation and neutralization of the virus in tissue culture is the most positive identification method and has a specificity and sensitivity of 100%. Viral culture by inoculating animals, chicken embryo tissue culture sample and virus multiplication, by producing changes in the cell, called cytopathogenic effect. Serologic tests include complement fixation test. Higher investigations, tests inmunomorfológicas as both direct or indirect immunofluorescence, usually have a sensitivity of 80 to 90% compared to tissue culture and molecular methods such as PCR and ELISA. Other more recent methods of investigations include preparation of mouthwash, CSF – pleocitosis 50% high protein and 25%.
MRI shows brain stem and spinal cord injuries. Given the self-limiting nature and mild cutaneous manifestations of herpes zoster, only symptomatic treatment is required. However, the acute phase of the disease in most patients younger immunocompetent can be debilitating and requires appropriate treatment as topical agents. The lidocaine patch (5%) will give quick relief. Calamine lotion and cream on open lesions of capsaicin in the healed lesions may be applied to reduce pain and itching. Painkillers such as paracetamol 325-650 mg three times a day / four times a day, ibuprofen 200-400 mg four times daily can be used systemically. Antiviral agents such as acyclovir 800 mg, 5 times daily orally, reduces pain and symptoms by inhibiting DNA synthesis and viral replication. The pain and numbness of PHN results from a combination of both central and peripheral mechanisms. The use of antiviral drugs, with systemic corticosteroids and short course tricyclic antidepressants during the acute phase of the disease can reduce the incidence and severity of PHN. Prednisone (60 mg twice daily, gradually over 3 weeks) acts as an anti – inflammatory by reducing inflammation and degree of neuritis. Tricyclic antidepressants such as amitriptyline, nortriptyline, imipramine, desipramine 25 mg given orally before bedtime for PHN. Anticonvulsants such as phenytoin 100 to 300 mg, Carbamazepine 100 mg orally at bedtime are given to control neuropathic pain (lancinating). Gabapentin 300 mg three times daily for four weeks is effective in treating pain associated with NPH and often sleep disorders.
When medical treatment has been ineffective in the management of intractable pain blocks or surgery nerve at peripheral nerve or dorsal root they have been effective. Varicella vaccines reduce the incidence of shingles and can be given to people who are susceptible and are at high risk of developing complications from chickenpox and children> 1 year old. Passive immunization zoster immune globulin (ZIG) is prepared from blood donors with high titers of anti-VZV and active immunization (0. 5 ml subcutaneous injection of live attenuated Oka / Merck VZV vaccine) is principally for increase resistance to infection. Early pre-eruptive herpetic pain can simulate a severe toothache and lead to unnecessary oral surgery or dental treatment. However, demonstrations with extensive necrosis and alveolar tooth spontaneous exfoliation are rare. Antibiotics and antiviral medicines along with oral hygiene measures, frequent irrigation of the wound and local anesthetics and antiseptic mouthwashes can help control bone destruction and other serious complications. Although it is a relatively rare disease that occurs among older people and usually benign, it is associated with morbidity and potential mortality, especially in immunocompromised patients. When the full clinical picture of HZ presents with pain and unilateral vesicles, distributed along the nerve, the diagnosis of HZ is not difficult. The problem of diagnosis arises during the prodromal period, when pain is present, without injury. During this stage, the differential diagnosis of severe prodromal pain should include dental pulpitis. A more difficult problem of diagnosis is pain and paresthesia caused by the HZ virus without lesions developing along the path of the nerve called Zoster Sine Herpete. Diagnosis is based on these clinical symptoms and serological testing of an antibody titer background.
Varicella and HZ is usually diagnosed by the classic clinical presentation, however, atypical presentations can make diagnosis more difficult. As prevention is always better than cure, early diagnosis and treatment of HZ can prevent the severity and complications of this infection.
The varicella-zoster virus that cause herpes zoster, can remain for years in nerve cells without causing symptoms. When shingles is an infection caused by a virus that leads to an itchy and painful skin changes at various points of the body and corresponding drug treatments makes necessary. For more information, see the main article herpes. The herpes zoster is a subset of the herpesviruses. The virus is referred to as “human herpesvirus-3” (HHV-3). It is believed that about 90% of the population carry herpes virus in the body. This rest trigger long years without a corresponding infection. Come but certain factors together, such as Stress, can lead to an outbreak of a herpes infection. When herpes zoster infection, which becomes visible in the form of shingles, is the varicella zoster virus. Patients who carry this virus in them or become infected with this, usually suffer in recent years, a chicken pox. Despite cure this disease, the virus remains in the body. Mostly a lifetime it may be unnoticed available and free of symptoms. In some cases it happens that it triggers a second infection over time, which then comes to light in the form of shingles.
It is thus one of the few pathogens that can trigger two completely different diseases with a time difference. Self Test Herpes Are you suffering from a herpes or other disease? Answer to 16 short questions and learn whether you have herpes, and what treatment options exist. Here `s directly to the test Herpes The virus is very easily transmitted by droplet infection (sneezing) and through mucous membranes and the transmission is mostly already in childhood or teenage years, which regularly performs in kindergartens to many infections. Without latently infected or immune human, it is practically inevitable that allow them to infect a living in the same household man who is acutely ill with chicken pox or shingles. If the virus once taken, it does not necessarily come directly to an infection. Often, the virus can remain in the body for years without causing symptoms. Test for shingles Do you suffer from shingles? Answer to 15 short questions and learn if you suffer from shingles, and how these can best be treated. Click here directly to the test shingles
After infection, it takes about two weeks to a rash occurs. This time is called incubation period. In the early phase of an outbreak of shingles, it can even come to severe pain in the area of the nerve affected section. The pain is described as pungent and unpleasant. They do not occur permanently, but may differ in intensity from day to day and increase lead to unbearable discomfort. The pain follows a characteristic rash, consisting of redness, Hautschuppungen and surveys. The skin irritations are often not widely, but rather point-like. However, the overall view of all point-like lesions can eventually have the appearance of a large reddened face. In another disease state may occur filled blisters in the skin. The skin may itch correspondingly strong but still also very painful in every stage of the disease and lead a corresponding impairment in everyday life with them. In chickenpox the rash with small oval bubbles and crusts accompanied. Usually even the buccal mucosa is affected. The patients, however it is usually good, a real malaise usually is not, but occasionally there is a fever.
This phase of the rash lasts about a week, the blisters heal fortunately without scars. Exception bubbles that have ignited after scratching and therefore often scarred. Dangerous are not chickenpox for otherwise healthy. In people with immunodeficiency (after organ transplantation, HIV patients, burn victims), however, the risk of uncontrolled spreading infection that then leads to death in up to 40% of cases. Ill a pregnant woman to varicella zoster, is a remote risk of nerve and eye damage the unborn child. In the early stages of pregnancy can lead to miscarriage of acute infection. If the herpes zoster attacks the eye, there is a risk of blindness, since the cornea healed after infection often pitted and therefore the sight is reduced. In an attack of the face occurs often on a one-sided paralysis of facial muscles (facial paralysis). This is very uncomfortable, but usually not permanent. Another complication is the infection of the ear. Here, the hearing and sense of balance is affected on one side, the complaints do not always regress. The skin of the body is covered with sensory nerves, which are to ensure the touch, the pain and temperature sensation. Each larger skin surfaces is provided by a particular nerve.
Each of a particular nerve-provisioned area is designated by a letter and a number, and is called a dermatome. The spread of the lesions found mostly strictly dermatomgetrennt place, that Affected skin areas are delineated mostly sharp and end directly to an adjoining dermatome. After a chickenpox disease has healed, some viruses remain inactive in the so-called dorsal root ganglia. These are collections of neurons in the vicinity of the spine. The terminal branches of such spinal each supply a specific dermatome. In the dorsal root ganglia, the virus often remain decades. Sometimes, especially in old age, the viruses are reactivated and then infect the dermatome. Most then ignited a clear-cut belt-shaped surface, often in the area of the chest, sometimes in the face or neck. This caused by the reactivation of the virus disease is called shingles. The diagnosis is usually made on the basis of a visual diagnosis, since the propagation pattern of skin irritation is characteristic and is geared to the body’s dermatomes. Self Test Herpes Are you suffering from a herpes or other disease? Answer to 16 short questions and learn whether you have herpes, and what treatment options exist.
Here `s directly to the test Herpes In lesser extent, one can treat shingles conservative, that is, with cool packs and with appropriate ointments try to minimize the itching. To a greater extent shingles but must be treated consistently with medication. The drug of choice is acyclovir, which can be given both as an ointment or as a tablet systemically. For severe pain in the area of the skin can reduce the nerve pain are also trying with the drug gabapentin. In this combination even severe cases of herpes zoster infection are to get to grips with in many cases. The duration of treatment varies and depends on the severity of the disease. Risk factors of suffering from shingles at a young age by cooked chicken pox disease frequent and intense contact with carriers of the varicella zoster virus an ailing immune system: patients whose immune system is weakened, either by medication or by stress, a significantly higher risk of suffering from shingles as immunologically balanced patients. Test for shingles Do you suffer from shingles?
Answer to 15 short questions and learn if you suffer from shingles, and how these can best be treated. Click here directly to the test shingles For more information on herpes zoster can be found here: For more general information that may be interesting for you For an overview of previously published issues of dermatology at Dermatology A-Z.
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exantemáticas no viral dermatoses exantemáticas no viral dermatoses R. Grimalt MOLLUSCUM Concept Molluscum contagiosum (MC) is a disease caused by a virus of the poxvirus family, is a virus large (200-300 nm) and very poorly immunogenic, manifested by the presence of one or more elements nodular papules if fully developed are shown a typical central umbilication. The incubation period may exceed three months. Clinic Lesions appear in outbreaks, often during the spring and fall, as small papules 3-6 mm in diameter pearl color and typically umbilication. Injuries are completely asymptomatic and tend to be located in an asymmetric manner in previously damaged areas; ie MC virus can not penetrate healthy skin, so it only infects wounds or eczematous skin. From a practical standpoint the MC only appear in atopic children, and do so in eczematous areas, whether intense, almost imperceptible or only with eczema. Diagnosis MC diagnosis is easy.
The umbilicación of asymptomatic lesions occurring in varying numbers in areas of atopic eczema, along with the speed of the appearance of new lesions, is helpful for diagnosis. contagious on the forearm of a teenager mollusk. Diagnostic and therapeutic protocols in pediatric dermatology 17 R. Grimalt differential diagnosis Folliculitis can be confused with MC. First, instead of a umbilicación show a central area pustulizada and respond to antibiotic treatment. Follicular hyperkeratosis can be very difficult to distinguish from early forms of MC. Both types of company are located in the area of atopy areas (arms and thighs) and can often coexist. The unique and large MC may also prove difficult to differentiate from viral warts. The attempt to start the lesions by spoon to differentiate warts, which are not started with a spoon, the MC, they do.
MC can hardly be confused with insect bites multiple (flea) or some rash diseases (rash periflexural asymmetric childhood). Treatment There is controversy as to whether or not to treat MC. It seems clear that the action of the doctor does not change the course of the disease nor the possibility of recurrence. More than recurrences, new MC correspond to the clinical training of new elements and should be autocontagiados incubation period, around the MC which kicked off with spoon. Aesthetic or curettage psychotherapeutic effects of MC can be very useful on some occasions. All aggressive treatments (curettage, electrofulguration, cryotherapy, pinch clamp, trichloroacetic acid) can leave scars both dermatological and psychological. Isolate MC children can avoid infection, but in most cases the children predisposed (atopic) suffer MC, and nonatopic not be infected with them. Immunomodulators may help resolve the viral infection. Among the most used, cimetidine at high dose, 40 mg / kg. / Day for 3 months has proven effective. HERPES SIMPLE Concept Herpes simplex (HS) is an infection caused by a virus of the family Herpesviridae, DNA virus, 160 Kd, human exclusive reservoir which two serotypes are known HSV-I infection and
Herpes simplex in periocular area. 18 Diagnostic and therapeutic protocols in pediatric dermatology exantemáticas no viral dermatoses HSV-II. The first affects the upper trunk and causes 95% of pediatric cases and the second is located in genital mucosa and may be a sign of suspected sexual abuse in children. Clinically manifested by vesicular lesions gathered in clusters on a eritematoedematosa base and often accompanied by a discreet satellite lymphadenopathy. The incubation period of the disease can vary from 2 to 12 days. Clinic The disease causes two stages: primary infection and herpes recurrences. Herpetic primary infection occurs by external contact with another infected person. It can cause symptoms or go unnoticed. When causes obvious changes, often it is a severe infection that may be associated with fever, joint pain and malaise and its most frequent sites that depend on the site of contact are: the oral mucosa (primary herpetic gingivostomatitis), haw (keratoconjunctivitis herpetic), around a nail (herpetic whitlow) and genital mucosa (herpetic balanoposthitis and vulvovaginitis).
Microvesicles clustered in the area causing burning, itching and pain often affects appearing. Relapses occur by reactivation of the virus, not by external contact and tend to be of shorter duration. Always they tend to be located in the same area and can follow different triggers: sunburn, banal digestive processes, mood changes, etc. Diagnosis The diagnosis of primary HS usually be easy for the pomp the clinical picture and by the appearance of vesicles characteristics clustered with clear and small in anatomical areas described liquid content. The evidence Tzanck citodiagnóstico classical degenerating cells ballooned. For recurrences, the patients themselves, in most cases, make correct self-diagnosis. In 90% of adult subjects can be found HSV-I antibodies and 30% against HSV-II, but only 30% of all clinical symptoms have manifested. differential diagnosis Herpetic primary infection may be difficult to distinguish from a fixed erythema pigment, especially if presented as a felon. The initial herpes zoster, without metameric distribution ( “zoster herpetiformis”), can be quite impossible to differentiate, and only course in successive weeks allows the diagnosis. Relapses and recurrences can be confused with impetigo, and sometimes HS (even if they are treated with topical corticosteroids) may impetiginizarse. Diagnostic and therapeutic protocols in pediatric dermatology
19 R. Grimalt Treatment There is controversy as to whether or not to treat HS. Treatment with topical or oral antiviral may speed healing but does not resolve the infection. It seems clear that the action of the doctor does not change the course of the disease nor the possibility of recurrence. The isolation of children with herpetic primary infection can prevent contagion. Anyway cause persistent infections HSV therefore infected child is permanent carrier infecting virus and can be independent of the clinical symptoms. The most commonly used antiviral drugs are acyclovir, valacyclovir and famciclovir. Its price does not seem to justify its modest efficacy. SHINGLES Concept Herpes zoster (HZ) is a skin virasis manifested by neuralgic pain and a vesicular rash distributed in the peripheral territory of innervation of a sensory ganglion (metamere).
It is caused by the varicella zoster virus (VZV) DNA virus 90 Kd. Infection with this virus usually occurs from contact by air and non-immune subjects causes chickenpox. During this disease from skin or mucous membranes, the virus reached by ascending neural pathway to the skull-spinal sensory ganglia where it is integrated into the cellular DNA to escape immune control. In these ganglion cells continued viral replication would occur, for another blocked by host defenses side. Only when the latter descend to a certain level viral replication would become effective causing the occurrence of shingles many years later. Clinic The disease manifests with pain and paresthesias in the territory of innervation of a sensory ganglion, usually accompanied by a skin tenderness and sometimes headache, malaise and / or fever. A few days later the erythematous plaques initially then begin to appear in the proximal areas and in the more distal parts of dermatómero affection, above the typical clustered said plates are grouped vesicles. In most cases it is Herpes zoster chest in a 1 year old girl. twenty Diagnostic and therapeutic protocols in pediatric dermatology exantemáticas no viral dermatoses
You can appreciate a regional lymphadenopathy and 30% are vesicular lesions remote from the affected area. The degree of pain intensity in the HZ is increasing with age, so it is rare to see a clinic in young children and is more common these complain of discomfort in the affected area when adolescence and beyond. Depending on the location, they may appear specific clinical aspects and even some complications. In the ophthalmic HZ can be keratoconjunctivitis and iridocyclitis. In the HZ halitosis oropharyngeal and there may be difficulty swallowing; RamsayHunt’s syndrome, when the HZ affects the ear canal also can be associated with dizziness and paralysis of the facial nerve. The disease resolves without treatment in 2-4 weeks. 10% of adults and especially in the elderly subjects may be residual post-herpetic neuralgia. Relapses can be seen in 4% of subjects. The HZ affecting more than one dermatome, or have a very wide distribution, should be suspected some kind of immunodeficiency. Diagnosis The variety of HZ zoster sine herpete can be very difficult to diagnose from being unable to appreciate the presence of the classic vesicles in the painful area. The anti VZV IgM and IgG both can be useful. Generally other clinical forms are easily diagnosed by metameric distribution of lesions which is very suggestive.
differential diagnosis The differential diagnosis is necessary to consider neuralgias and neuropathies of other causes, herpes simplex and ringworm (contact dermatitis plants). Treatment There is controversy as to whether or not to treat HZ. Treatment with oral antivirals can accelerate healing but does not influence the appearance of a possible post-herpetic neuralgia. Isolating children with chickenpox does not prevent development of HZ in adults. The most commonly used antiviral drugs are acyclovir, valacyclovir and famciclovir. Its price does not seem to justify its modest efficacy. The only really important thing is to treat pain. PHN in adults treated successfully with tricyclic antidepressants Diagnostic and therapeutic protocols in pediatric dermatology twenty-one R.
Grimalt Human Papillomavirus Concept The human papilloma virus is a DNA virus, 50 Kd, 70 genotypes of human reservoir exclusively in children can cause common warts and genital papillomas. Genotypes 6, 11 and 16 are those that cause genital lesions and should be a sign of suspected sexual abuse of children. The incubation period is variable from 1 to 16 months. Flat warts on the face of an atopic child. Clinic Common warts (VC) appear as raised lesions (papules, nodules or epidermal vegetations) rough surface, often Verru-ciforme in trauma-tizables locations. In children, the periungual area is very characteristic and knees, hands, chin area in atopic (eczema is a microherida) and soles of the feet (plantar warts). In this last location the VC appear as outgrowing and painful on palpation hyperkeratotic lesions, especially the lateral pressure between toes Flat warts are papules a few millimeters in diameter flat surface and slightly keratotic yellowish, isolated or gathered in small groups, which mainly affect the face area in children. Filiform warts affect almost exclusively periorificial areas of the face as keratotic lesions with a sharp end. The genital warts or papillomas appear as totally asymptomatic genital lesions outgrowing locations, with trimmed margins (cockscomb). Verruciform epidermodysplasia is an autosomal recessive genodermatosis where a sensitivity of the epidermis papovavirus infection of a specific serotypes HPVs 5 and 8 and also serotypes flat warts (HPVs 3 and 10).
These lesions tend to become squamous cell carcinomas when they act as a cocarcinogens ultraviolet irradiation. Clinically they presented as a series of papulosos elements, similar to flat warts on the face and back of hands. Diagnosis The diagnosis of VC used to be easy usually the clinical picture. 22 Diagnostic and therapeutic protocols in pediatric dermatology exantemáticas no viral dermatoses Histological examination epidermal hyperplasia evidenced by the koilocytosis feature (keratinocytes with pyknotic nuclei and perinuclear clear halo). differential diagnosis Only the differential diagnosis of plantar warts (VP) deserves attention. The callus or heloma may be indistinguishable to the naked eye of a VP Callus always located in areas. pressure, VP may or may not do. The callus is painful to pressure while it is VP lateral pressure or pinching.
Callus dermatoglyphs keeps intact, while the VP no. A maneuver that can be useful to differentiate from one another is scratching scalpel through the lesion. If punctate areas appear blackish it is a VP if the image of an onion halved in concentric rings, it is displayed. callus. Treatment There is controversy as to whether or not to treat VC. The action of the doctor does not modify the course of the disease nor recurrence possibility. There is no evidence that affirms that the treatment of genital warts eradicates or affect the natural history of HPV infection. Treatment only seeks to destroy VC, there is sure to decrease the infectivity of the wearer. As autoplicación treatments can be used all kinds of caustics, keratolytic and irritants that get sometimes trigger a patient’s immune response against HPV and resolve the clinical picture. Imiquimod 5% cream, is new, very expensive and can have a similar effect. Cryotherapy, electrofulguration, and CO2 lasers can destroy some injuries, but not modify the course of the disease, they are painful and can leave permanent scars. OTHER poxvirus infections Concept
Poxviruses are the largest group of DNA, thus reaching up to more than 300 nm. Among the infections that cause they include: smallpox vaccine, the node computers, orf (orf) and molluscum contagiosum that has already been studied previously. Clinic The clinic of these diseases is not common and individually studied for each specific pathology. Diagnostic and therapeutic protocols in pediatric dermatology 2. 3 R. Grimalt Vaccine: when “smallpox vaccination” was needed, a modified poxvirus strain called officinale, showing cross-immunity to poxvirus variolae was used. After three days of vaccination, either by scarification, multiple punctures or intradermal injection, erythema was produced, and four to six days appeared a papule that transformed a week later in vesicopústula and later desecaba, umbilicaba and He is leaving a scar characteristic. Nodule milkers: also called paravacuna because it is caused by the paravacuna virus at the site of contact, usually hand milker, determines small inflammatory papules that become tubers little painful covered with a brown crust, to detach, leaves one exulcerada surface heals smoothly in approximately one month. There may be a regional lymphadenopathy and become secondarily infected.
In this case you will need treatment because the virus infection heals spontaneously. orf (orf): the poxvirus ORFI cause disease in animals and they transmit to humans. Appear similar to “nodule milkers’, preferably in the nose, lips and hands papulopustules. It is very common bacterial infection, then observed lymphangitis and adenitis. The infection, which lasts about five weeks, going on farmers, farmers and veterinarians and requires only symptomatic treatment. Diagnosis The diagnosis of “vaccine” is performed by the clinical anamnesis. Both the ‘Orf’ and the ‘node milkers’ are unusual in children. differential diagnosis Insect bites and localized skin infections (impetigo) can be difficult to differentiate. Treatment All these diseases heal without treatment. In cases where there is a bacterial infection should make appropriate antibiotic therapy.
Bibliography 1. Armijo M, Camacho F: Treaty of Dermatology. Medical ed classroom. Madrid 1998. 2. Burpo RH: Common antiviral agents used in women’s and children’s care. J Obstet Gynecol Neonatal Nurs 2000; 29: 181-90. 3. Diven DG: An overview of poxviruses. J Am Acad Dermatol 2001; 44: 1-16. 4. Hurwitz S: Clinical Pediatric Dermatology.
Saunders eds. Philadelphia 1988. 24 Diagnostic and therapeutic protocols in pediatric dermatology exantemáticas no viral dermatoses 5. Inceoglu F: Orf (ecthyma contagiosum): an occasional diagnostic challenge. Plast Reconstr Surg 2000; 106: 733-4. 6. Liota E E, Smith KJ, Buckley R, Menon P Skelton H: Imiquimod Therapy for Molluscum, Contagiosum. J Cutan Med Surg 2000; 4: 76-82. 7. Lorette G: Suspected sexual abuse in children.
Ann Dermatol Venereol. 2000; 127: 549-54. 8. Mahalingam S, Foster PS, Lobigs M, Farber JM, Karupiah G: Interferon-inducible chemokines and immunity to poxvirus infections. Immunol Rev 2000; 177: 127-33. 9. Mourtada I, Le Tourneur M, Chevrant-Breton J, Le Gall F: Human orf and erythema multiforme. Ann Dermatol Venereol 2000; 127: 397-9. 10. von Krogh G, CJ Lacey, Gross G, Barrasso R, Schneider A: European course on HPV Associated pathology: guidelines for primary care physicians for the diagnosis and management of anogenital warts. Sex Transm Infect 2000; 76: 162-8. Diagnostic and therapeutic protocols in pediatric dermatology 25
Profile ID #  Your browser does not support script It is not Intended to be a comprehensive review of the Entire standard. Sore feat Dorian – Bad Boy Is Back (Lyrics Video) (Color Availability Varies By Region) B. HOWEVER, there is no guarantee did the virus will not attack again. Data nasterii We recommend the use of this shingle to replace existing wood shake roofs. The designation of a material as “PACM” may be rebutted Following procedures specified in the standard. Sore \x26amp; Dorian – Save me [Studio Version] – Original song Promotes longer life, extended durability to protect effectively, it must have been repeated every 6 months at least continuously from the foal time and always only when the immune system was fully fit , • The remaining 20% of the cold sore cases are gene rally Caused by the herpes simplex virus type 2. Trebuie sa fii cel putin Membru gratuit sa poti vedea asta We Both us IKO Cambridge, and PABCO Premier 30 year shingles. Class IV Asbestos Work – means maintenance and custodial activities during construction Which employees contact but do not disturb ACM or PACM and activities to clean up dust, waste and debris Resulting from Class I, II and III activities. Ruby feat. GAFLEX® coating This makes vaccination (any kind of vaccination) with them often quite complicated! . It is the place where facial nerves meet and connect to secondary nervous system Judetul / Provincia Tile Roofing: Permissible Exposure Limit (PEL) Dorian – Mi-ai intrat in cap [Official video HD] You are visitor: Even that one will pay attention. They are not the causes of cold sore.
Trebuie sa fii cel putin Membru gratuit sa poti vedea asta Price per square – standard weight – $ 112th 1 fibers per cubic centimeter. Brighi feat. there may be a vaccine (with no matter what vaccine and against) are a burden, with the disadvantages for them: Stadium Unpleasant it, if they had been infected or already were herpes carriers and a flare-up of infections to be feared would. • 33% of the total affected people do not get cold sores Throughout Their life span despite the fact thatthey are affected by the virus. Culoare ochi The standing seam metal system is a very reliable metal roofing system TSI and surfacing materials in buildings or substrate Constructed no later than 1980 Bruno Mars -. . Liquor Store Blues ft Gerombolan vesicle yang tersebar sesuai dengan dermatome yang meruasi oleh satu ganglion syaraf sensors , this helps but only in the short term, by the gradual, long-lasting infection course is the but actually a long time necessary. If the immune system is strong, it will prevent the herpes simplex virus Type 1 and Type 2 from Reactivating easily. Nefumator TPO is a lot cleaner then the traditional hot tar or mop down roofing systems, and is what we suggest When at all possible. On multi-employer work sites, all employers of employees who will be performing work within or Adjacent to areas Containing test material Pac Man – Bariglosenye Klasifikasi Herpes Zoster distinguishing them can be the increase, the causes acute flare. Including vitamins and protein supplements is therefore essential at times.
job Trigenirus yang menimbulkan kelainan pada mata Cabang Kedua dan yang ketiga menyebabkan kelainan kulit pada daerah persyarafan. The signs must identify the material All which is present, its location, and Appropriate work practices thatwill Ensure ACM / PACM will not be disturbed. Mario Fresh feat. Diakibatkan gangguan N. Fasiolis dan optikus sehingga memberikan gejala paralysis otot muka (Paralisis Bell) kelainan kulit sesuai Tingkat persyarafan, kliris vertigo, gangguan pendengaran, regtagnius dan juga terdapat raisea gangguan pengecapan. Physical fatigue or stress is pretty easy to deal with. Trebuie sa fii cel putin Membru gratuit sa poti vedea asta Berlangsung dalam waktu dan singkat kelainan kulitnya hanya beberapa berupa vesicle dan eritem. CANCER AND LUNG DISEASE HAZARD. Kelainan kulit dan unilateral segmental ditambah yang menyebar Secara Generalisata berupa vesicle soliter dan ada umbilikasi. Case ini terutama terjadi pada orang tua atau pada orang yang sangat kondisi fisiknya lemah, misalnya penderita: Umforra malignant. It is the medical science Which thinks this and has proved it. Cautare culoare par Pemeriksaan Penunjang The competent person must have the qualifications and authority required by 29 CFR 1926.
Dorian – Mi-ai intrat in cap (Live la Radio ZU) Diagnosa Banding herpes simplek Even if 1% of the stress is reduced, it can Significantly change your health Because psychology is very deeply associated with health. Nu beau deloc, Ocazional, Frecvent Penyakit dengan efloresersi bulla; pemfisus vulgaris Ensure (by on-site inspection) the integrity of the enclosure or containment Sore) [Official video HD] Penatalaksanaan Therapi sistemik umumnya bersifat simptomatik untuk nyeri diberikan analgesics jika disertai infeksi sekunder diberikan antibiotik. Honestly, most of us do not think about what we are eating. Varsta cautata Therapi topical berga device pada stadium: Ensure notification requirements are met did David Guetta \x26amp; Showtek – Bad ft Bila ulserasi dapat diberikan salep antibiotik. . Kompres pada yang daerah terserang: Lysine helps in fighting the herpes simplex virus type 1. 05. istirahat
Treatment It may prescribe an antiviral that helps reduce pain, prevent complications and shorten the course of illness. It should be away from people to avoid spreading the disease. symptoms The first symptom is usually pain or burning on one side, appearing before the eruption. skin patches are formed, followed by blisters. The blisters break, forming small ulcers that begin to dry and form scabs Herpes zoster. It is a skin rash caused by a viral infection of the nerves beneath the skin. The virus that causes it is the same as that of the varicela. Es a highly contagious disease. Shingles usually disappears within a month It disappears at 3 weeks and usually not appear again.
When pain lasts for months is called post-herpetic neuralgia. PHN occurs when nerves have been damaged. The pain ranges from mild to very severe. It is more likely to occur in people over 60 years. Causes After chickenpox, the virus remains inactive. Shingles occurs when the virus is reactivated after many years. It can occur at any age. There are more possibilities if: He has over 60 years of age. He gave chickenpox before the age of 1 year. Your immune system is weakened. complications
Another attack of shingles Bacterial skin infections Blindness (if herpes occurs in the eyes) Deafness Infection, including encephalitis or sepsis. Ramsay Hunt Syndrome Prevention Avoid contact with skin rashes and blisters of persons with shingles or chickenpox. US ACIP has recommended that adults over age 60 receive the vaccine against shingles. Complications with SN Encephalitis herpes zoster, if it affects the brain (brain). Meningitis herpes zoster, if it affects the membranes covering the brain (meninges). Herpes zoster myelitis, if it affects the spinal cord.
If it affects the nerves Guillain-Barre syndrome can develop. In rare cases, shingles can be extended to the whole body and internal organs. CARMEN MORENO CAMPOS
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Shingles (herpes zoster) Shingles along the neck of the C3 with pain behind his right ear Herpes zoster, colloquially usually called shingles, is a viral disease that occurs primarily through a painful, strip-like rash with blisters on one side of the body in appearance caused by the fact that the inflammation of a nerve (z. B. a ganglion) of the surrounding Dermatom overlaps. The disease is caused by the herpes family of viruses belonging varicella zoster virus (VZV) and usually occurs in older people or those with a weakened immune system (due to stress, as a result of other diseases such as AIDS or by a special treatment) , The virus is often transmitted in childhood, and caused in this phase of life chickenpox. A herpes zoster is always an endogenous reactivation of a previously taken place VZV infection. etymology The popular German term “shingles” comes from the fact that the reddish rash with particularly striking expressions often can gobble from the spine, starting half or both sides, like a belt around the body and there causes a so-called “erysipelas”. . The collective term “erysipelas” is an archaic expression of an acute, localized dermatitis, which has often been used indiscriminately for various diseases with different causes. The scientifically correct term Herpes Zoster is derived from the Greek “herpein”, “crawl” to German and also the Greek word for girdle ( “zoster”). The English term for the herpes zoster, shingles, in turn, is the Latin “cingulum” borrowed for belts.
Often the (abbreviated) terms “zoster” (for herpes zoster, caused by the varicella zoster virus VZV) and “herpes” (simplex for herpes, a caused by herpes simplex virus disease) confused, although it is different to two diseases is that significantly differ in excitation and in particular in the sequelae. Epidemiology In Germany every year are affected about 350000-400000 people on a herpes zoster, approximately 2/3 of which are over 50 years. Since up to 40 years around 98% of the population with the varicella zoster virus had contact (usually either clinically manifest in the form of chickenpox or in form of a silent Feiung), all people are virtually risk and for approximately 25-30% of the population suffer in their lifetime a zoster, from the age of 85 years, the risk is as high as about 50%. pathogen As a causative agent of this disease, the varicella zoster virus (VZV) is – also known as human herpes virus-3 (HHV-3) – detected. This virus is an enveloped, double-stranded DNA virus (dsDNA) and belongs to the family Herpesviridae, subfamily to Alphaherpesvirinae and the genus Varicellovirus. All viruses in this family are equipped with an icosahedral capsid (with a composed of triangular faces protein shell), each of which is still surrounded by a membrane. Between them can be found as a special feature, the so-called amorphous tegument protein material having been only partially understood function. The varicella zoster virus is used relatively close to the herpes simplex virus, but there is no cross-protection. It is estimated that around 90 percent of over-14-year-old Europeans by chickenpox infections already carriers of varicella-zoster virus. The fact that except for significantly immunocompromised humans and not double infection or secondary infection (see also infectious) disease caused by these pathogens only extremely rarely takes a fatal outcome, showing on the one hand, that these viruses highly adapted to humans as their reservoir host are. The damage to the reservoir host to his death is not a beneficial effect on a virus because it is dependent on these host for its own propagation.
The triggered yet of this virus in reservoir host disease are ultimately only side effects of the infection. Nevertheless, fatal outcomes in Germany before coming to die the risk of chickenpox increases with age significantly (according to RKI to 31 / 100,000). transmission The first infection of a healthy person usually manifests itself in the well known “childhood disease” Chickenpox. The highly infectious virus that viruses are by droplet infection, ie direct inhalation of Ausatmungströpfchen (Exspirationströpfchen) of infected people, or through contact infection or smear infection transmitted with the viruses of the fallen on objects or body surfaces infectious Exspirationströpfchen if they then immediately through the mucous membranes, for example in the mouth, nose or eyes enter the body. Since the pathogen in the air are able to survive only for about ten minutes, a transmission by lying about clothing or toys usually need not be feared. Even if those affected are usually after a chickenpox disease for a lifetime immune to the disease, the virus remains after resolution of chickenpox in the body and can later, for example, triggered by stress or a weakened immune system, in rare cases, by sunlight (UV be reactivated light! ). The virus remains latent in the nerve roots of the spinal cord, the so-called spinal ganglia, and in the ganglia of the cranial nerves. Shingles is therefore no infection in the true sense, but the re-activation of the varicella zoster virus, after a more or less long latency period. For people who were sick in the childhood chickenpox and immunocompetent (fully active immune system) are (d. H. , Which are not immunosuppressed), there is generally no risk of becoming infected by a herpes zoster patients, since a transmission of the virus is carried only by the virus vesicles with contaminated contents, but not like a chickenpox sufferers via the respiratory tract as a droplet infection.
The Herpes Zoster can not be transmitted directly as such; it always takes only a reactivation of an already had taken place infection. ( “No Zoster without prior chickenpox”) of the definition of incubation can not speak in this disease of such a. Disease process / symptoms History of Herpes Zoster. Initially, small raised points (1) forms which pass into blisters (2). The blisters fill with lymph and break (3), crust over (4), and finally disappear. A post-herpetic neuralgia can sometimes occur due to nerve damage (5). a) skin surface; b) nerve fiber; c) activated viruses; d) inactive viruses The nerve tissue ignites upon activation of the latent virus. Symptoms include burning and some pain in the area of skin supplied by the affected nerve trunk and in the nerve trunk itself. Occasionally, advance and otherwise observed as the disease progresses general malaise, fatigue, tingling, fatigue, exhaustion and a mild fever. Before the actual onset of the disease often occur pain in more or less large areas of the body where the nerve tissue becomes inflamed and often partially destroyed as a result. Why some suffer just before the actual outbreak of back pain, dental pain, or the like.
Two to three days after the onset of initial pain easily occur raised, reddened bodies and form bubbles in the further course nodules. The blisters fill with a clear or white, purulent fluid, which is infectious. The redness and blistering usually occurs strongly localized on (around the nerve cord) and usually only on one side of the body; in rare cases it can lead to both sides infestation. In some cases, the rash can also be canceled altogether. After a few days, the blisters burst and scab. This phase can last 1-4 weeks. Localization on the chest The localization of shingles is determined by the area supplied by the affected nerves. Mostly occurs zoster in the thoracic region of (intercostal nerves). Occasionally, back, arms or legs may be affected. In ophthalmic zoster face and eyes are affected (ophthalmic nerve in the trigeminal nerve). If the eyes are affected, partial or complete blindness can result by corneal scarring. For infection of the facial nerve (facial nerve) can cause temporary paralysis or loss of taste.
Zoster oticus called an infestation of the ear canal and the outer ear or. Possible consequences are here with the zoster typical severe pain hearing (cochlear nerve) and disorders of balance (vestibular nerve). Left untreated can result in permanent hearing impairment or deafness. “Zoster generalized satus” refers to an infection of the entire nervous system; this form of the disease is life-threatening, but usually occurs only at strong primary immune system suppression on (z. B. with AIDS, leukemia or other cancer types). Herpes Zoster also occurs in the genital area. He takes over the genitals large area up to the thigh. In lymphatic drainage of the skin affected area often can be detected activated lymph nodes. complications Ophthalmic zoster in face and eye Herpes zoster complications are relatively common with about 20% of cases. In particular, post-herpetic neuralgia (PHN), also known as postherpetic neuralgia (PZN) referred, is very common and causes severe, often described as a burning pain.
The PZN / PHN may even persist for life in the worst case and is unbearable for those affected to some extent. Such pain can drive even to suicide sufferers.   The rarer forms zoster zoster as generalized satus, ophthalmic zoster (10% to 15%, of which have ocular involvement 30-40%) are and zoster oticus sometimes counted among the complications. Not infrequently heal the sores only pigmentation and scarring (Unlike chickenpox, provided that these have not led by scratching, scarring). Other complications are rare and usually affect only highly immunocompromised. Complications include zoster meningitis (meningitis), zoster encephalitis (Hirngewebsentzündung) and zoster myelitis (inflammation of the spinal cord). therapy The varicella zoster virus can be treated with antivirals. Complications can only timely treatment can be reduced mostly in the Wrong-assessed by patients prodromal phase, so that this opportunity usually can not be used. It is important to early medical treatment with antivirals for very extensive findings, for example, involvement of the eye or ear, and especially with pre-existing immune deficiency (eg. , Tumor disease, severe diabetes mellitus or AIDS). Usually, the treatment with acyclovir, brivudine, famciclovir or valacyclovir, usually in tablet form. In more complicated cases (involving the eye, ear, spinal cord) intravenous treatment is necessary.
Usually the addition of strong painkillers is displayed. At about eight percent of the patients, the acute pain can not be affected by pain relievers. Cases of post-herpetic neuralgia (about 30% of patients still have four to five weeks after the crusting diffuse (without recognizable contours) or locally (locally) limited, partly severe pain) are often difficult to treat. Come into consideration here with painkillers and antidepressants and neuroleptics, sometimes even surgery. Treatment with electrotherapy (galvanization, electrical stimulation or transcutaneous electrical nerve stimulation) can relieve pain. However, skin lesions have to be considered (vesicles and pustules). Prevention / vaccination The highest for the patients responsibility to third parties is to avoid contact with pregnant women. Did this fact – particularly in the case of an unplanned ‘sudden’ pregnancy – no corresponding vaccination obtained and otherwise no or insufficient antibodies to the virus in the body, a chickenpox infection can cause during pregnancy to developmental disorders in children. In a chickenpox outbreak at the mother in the last days before the birth, there is even fatal injury to the child. The vaccine (Zostavax ™) from MSD Sharp \x26amp; Dohme, which lowers the risk of disease preventively to about half and the pain significantly relieves the remaining cases, was approved on 25 May 2006 in the US by the competent authority FDA. On 25 October 2006 recommended the Advisory Committee on Immunization Practices (ACIP), which is part of the U. S.
Centers for Disease Control and Prevention, the administration of the new vaccine to all persons older than 60 years.  The vaccine is already available in Austria, in Germany is to be expected with the vaccine during the year of 2008. He is allowed from 50 years. With such a vaccination 51 percent of cases could be prevented and a PZN by 66. 5 percent to be avoided. If, despite vaccination, yet shingles occurs, it is usually more significantly milder and with fewer complications.   References ↑ abGürtelrose shingles at gesundheit. de ↑ vaccination against shingles ↑ U.
S. Panel Backs Shingles Vaccine ↑ Herpes Zoster – Green Cross short often referred ↑ The original study by Oxman and colleagues in the New England Journal of Medicine A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults as “Shingles prevention study” Web Links Note Reference to health topics!
Since the virus in nerve tissue ignites this in a disease. Symptoms burning and pain in the area of skin which is supplied the affected nerve cord. Uncommon malaise is fatigue watching fatigue and slight fever. 2-3 days after onset of initial contact slightly raised erythematous places on the further course of bubbles forming. The blisters fill with a white purulent fluid which infectious The redness and blistering usually occurs strong (to the nerve cord) and mostly only on the body side to; in rare cases it can cause both sides infestation. In very rare cases the rash even be canceled altogether. After a few bubbles burst and scab. This may take 1-4 weeks. Mostly occurs zoster in the range of. Occasionally, the lumbar region arms legs may be affected. are in zoster ophthalmicus and eyes affected. For infection of the facial nerve is temporary paralytic symptoms and / or loss of come. If the eyes are affected may be by partial or complete blindness will result.
Oticus called an infestation of the ear canal. Possible are here with the zoster typical severe pain and disorders of balance. Left untreated can result in permanent or numbness. Zoster Generali Satus infested the entire nervous system; but this form of the disease life threatening typically occurs (for example, by AIDS leukemia or other cancer-forms) only under strong weakening of the immune system. Complications are rare and usually involve highly immunocompromised. Complications include (meningeal inflammation) Zoster encephalitis (brain tissue inflammation) and zoster myelitis (spinal cord inflammation). Even rarer zoster forms as zoster Generali Satus zoster ophthalmicus zoster oticus are occasional complications In rare cases remain pain consist healing. One speaks in such of post-herpetic neuralgia. The probability of this tends to be in the elderly more than younger. The varicella zoster virus can be treated with antiviral drugs is normally pre-treatment with acyclovir, famciclovir valaciclovir mostly locally as an ointment or drops. Exceptional cases is an intravenous treatment possible. severe pain is the additional administration of analgesics displayed.
Cases of post-herpetic neuralgia are often difficult to treat. This may include painkillers and antidepressants and neuroleptics sometimes even surgery. Books herpes zoster This article is licensed under the GNU FDL.
exactly three weeks ago I felt a stinging right where he had been wearing heart band after running the Metropolitan Park with Tao and Jose. We had had a good run and I thought I would have touched with a plant that caused an allergic reaction me. Then we went to El Valle de Anton and there itching and irritation band I was back watering to just where he had been the band’s pulse. I was thinking it was something strange, suddenly had been dirty heart band, or had been in contact with some rare cleaner. On Sunday I went pedaling curves Valley with Daniel and got a good shot of 50-odd kilometers and returned to Panama. Irritation and the band had changed his appearance and shared a picture of what was becoming irritation with our group of ultra-runners. The Rets once said Rompy, have shingles. What the hell is that? It is a recurrence of chickenpox, and my nor I had chickenpox in my medical history (how he would have a relapse). But that is what he had and would not wish on anyone. On Saturday night had passed an uncomfortable night with a pain in his side he could not explain, had not hit me with anything, why he would have a pain there? It turns out that the blessed virus stays in the body forever and when reactive (for a reason no one yet known) goes for nerve and therefore the condition is always one-sided. Pain is because the virus to reproduce within the nerve leaves everything mistreated and causes pain.
In fact, the whole band where I had pustules with the virus has been insensitive. Well, I spent a week very wrong with all the typical symptoms of chickenpox. I am recovered 100% of the virus and only me is post-herpetic neuralgia (pain in the side, sometimes it feels like a stab in the back). The point of this post is just to leave a record of where it was in terms of my physical condition, and where it was. He came recuperating from a foot injury but was already well advanced in recovery and was getting about 30 hours of exercise in the month. To stop my count was at 10 hours hours for the last 30 days. Today I went for a run to the Metropolitan Park with Daniel and Jose. In the park we find a group of Trizen who came to know the route to a career that Daniel will organize on June 22 in the park. We quickly left behind me and Joseph, I came by slow and gumming Lagarto last night. These people were flying through the thresher and the only way I kept with them was taking shortcuts to reach them. At the end of the PM I came around 10. 3km me when I usually measured 11km. The time was almost the same as always: 1:23:00.
I was running with the beats to 10 beats per minute more on average and running half a kilometer per hour slower. Again I returned to my training back in Fat Dog. The only good thing is that my foot is much better and now I can run without me is bothering foot pain. Now only I still back up the weekly mileage and hours of exercise. station had peaceful with three weekly exercise sessions, but since I have little time for you to regain my form for a 120-mile race: I have four months to be fit. If I include some rest I have less time yet. So it’s time to change the strategy and instead of making long few times a week runs, the best thing now is to do something shorter every day. Now I use frequently to regain the conditions that I lost. I hope my old body holds up. Share this: I like it: Like Loading . .
From Wikipedia, the free encyclopedia Herpes zoster on a patient’s neck Herpes zoster (also known as Shingles or Zona) is a disease in humans. The same virus causes chickenpox did so causes shingles. The symptoms are pain and a rash with blisters. General information Shingles is a viral disease produced by the varicella zoster virus (VZV), the same virus did causes chicken pox. Its symptoms include pain and a blistering rash did the occurs along the nerves did contain dormant virus. You can not catch shingles. HOWEVER, you can catch chicken pox through direct contact with someone who has shingles, by touching the area of the rash. Most people who get shingles are old. It sometimes infects younger people, or people with a Weakened immune system. Stress may trigger shingles.
The disease starts with tingling, itchiness, or pain on to infected person’s skin. After a few days, the disease causes a blistering rash. This rash may be on the trunk or face. The rash grows into small blisters filled with fluid. These blisters dry out and crust over for several days. The rash causes anything from mild itching to extreme pain. The rash stays in one region of the body. The shingles virus is contagious from person to person only by direct contact. For this reason, persons with shingles are advised to limit contact with Those Who are not immune to chicken pox, Those with Increased risk are young children and pregnant women. Contracting chickenpox When one is pregnant can be dangerous to the unborn child. If people have had chickenpox, They can not get chickenpox from someone else again. HOWEVER, it is thought that CONTACT with a shingles patient may trigger a person’s own dormant chickenpox virus to become shingles. Treatment
Doctors recommend antiviral drugs, steroids, antidepressants, anticonvulsants, and topical agents to treat shingles. The antiviral drugs acyclovir, valacyclovir, and Famcyclovir can reduce the severity of shingles. Prognosis Shingles can be very painful and itchy. It is not very dangerous to healthy people, and it Usually ends without major problems. The rash and pain last 3 to 5 weeks. Sometimes, serious problems like temporary, partial facial paralysis, ear damage, or encephalitis may occur. Persons with shingles on the upper half of the face need immediate medical attention: the virus may cause serious damage to the eyes. Most people who have shingles have only one attack of the disease in Their lifetime. HOWEVER, people with AIDS, cancer or weak immune system may have multiple attacks. Other websites NIH Facts About Shingles NINDS Shingles Information Page
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Shingles (herpes zoster) Shingles along the neck of the C3 with pain behind his right ear Herpes zoster, colloquially usually called shingles, is a viral disease that occurs primarily through a painful, strip-like rash with blisters on one side of the body in appearance caused by the fact that the inflammation of a nerve (z. B. a ganglion) of the surrounding Dermatom overlaps. The disease is caused by the herpes family of viruses belonging varicella zoster virus (VZV) and usually occurs in older people or those with a weakened immune system (due to stress, as a result of other diseases such as AIDS or by a special treatment) , The virus is often transmitted in childhood and causes in this phase of life chickenpox. A herpes zoster is always an endogenous reactivation of a previous VZV infection. etymology The popular German expression shingles arose because the reddish rash proceeding unilaterally or quite like a belt wraps at particularly pronounced manifestations of the spine to the body and there causes erysipelas.  The collective term erysipelas is an archaic expression of an acute, localized dermatitis, which was often used indiscriminately for various diseases with different causes. The scientifically correct term Herpes Zoster derives from the Greek herpein to German, crawl ‘, and also the Greek word for zoster, belt’ from. The English term for the herpes zoster, shingles, in turn, is the Latin cingulum for, Belt ‘borrowed. Often shortened terms zoster (for herpes zoster, caused by the varicella zoster virus (VZV)) and herpes are (simplex for herpes, a caused by herpes simplex virus disease) confused, although they are two different disorders which differ significantly in excitation and in particular in the sequelae.
Epidemiology In Germany every year are affected about 350000-400000 people on a herpes zoster, approximately 2/3 of which are over 50 years. The recent study in Germany has shown that about 306,000 people a year from age 50 to Herpes Zoster ill. This results in an annual incidence of 9. 6 per 1,000 people per year.  Since up to 40 years around 98% of the population usually either clinically manifest in the form of chickenpox or in form of a silent Feiung had contact with the varicella zoster virus, all men are virtually risk. Around 25-30% of the population suffers zoster during their lifetime. From the age of 85 years, the risk is as high as about 50%. pathogen As a causative agent of this disease, the varicella zoster virus (VZV) is – also known as human herpes virus-3 (HHV-3) – detected. This virus is an enveloped, double-stranded DNA virus (dsDNA) and belongs to the family Herpesviridae, subfamily to Alphaherpesvirinae and the genus Varicellovirus. All viruses in this family are equipped with an icosahedral capsid (with a composed of triangular faces protein shell), each of which is still surrounded by a membrane.
Between them can be found as a special feature, the tegument of amorphous protein material having been only partially understood function. The varicella zoster virus is used relatively close to the herpes simplex virus, but there is no cross-protection. It is estimated that around 90 percent of over 14 year old Europeans by chickenpox infections already carriers of varicella-zoster virus. The fact that except for significantly immunocompromised humans and not double infection or secondary infection (see also infectious) disease caused by these pathogens only extremely rarely takes a fatal outcome, showing on the one hand, that these viruses highly adapted to humans as their reservoir host are. The damage to the reservoir host to his death is not a beneficial effect on a virus because it is dependent on these host for its own propagation. The triggered yet of this virus in reservoir host disease are ultimately only side effects of the infection. Nevertheless, fatal outcomes also occur in Germany, where the risk of dying from the chickenpox, with age increases significantly (according to RKI to 31 / 100,000). transmission The first infection of a healthy person usually manifests itself in the well known “childhood disease” Chickenpox. The highly infectious virus that viruses are by droplet infection, ie direct inhalation of Ausatmungströpfchen (Exspirationströpfchen) of infected people, or through contact infection or smear infection transmitted with the viruses of the fallen on objects or body surfaces infectious Exspirationströpfchen if they then immediately through the mucous membranes, for example in the mouth, nose or eyes enter the body. Since the pathogens are infectious only for about ten minutes in the air, a transmission by lying about clothing or toys usually need not be feared. Even if those affected are usually after a chickenpox disease for a lifetime immune to the disease, the virus remains after resolution of chickenpox in the body and can later, for example, triggered by stress or a weakened immune system, in rare cases, by sunlight (UV be reactivated light! ).
The virus remains latent in the nerve roots of the spinal cord, the so-called spinal ganglia, and in the ganglia of the cranial nerves. Shingles is therefore no infection in the true sense, but the re-activation of the varicella zoster virus, after a more or less long latency period. (D. H. Immunocompetent and not immunosuppressed) For people who were sick in the childhood chickenpox and a fully-active immune system have, there is usually no risk of becoming infected by a herpes zoster patients as a transfer the virus but not like a done only by the virus vesicles with contaminated contents, chickenpox patients through the respiratory tract as a droplet infection. The Herpes Zoster can not be transmitted directly as such; it always takes only a reactivation of an already taken place infection ( “No Zoster without prior chickenpox”). Due to the definition of incubation period can not be said that such a case of this disease. Disease process / symptoms History of Herpes Zoster. a) skin surface; b) nerve fiber; c) activated viruses; d) inactive viruses Localization on the chest The nerve tissue ignites at a reactivation of the latent virus. Symptoms include burning and some pain in the area of skin supplied by the affected nerve trunk and in the nerve trunk itself.
Also, general symptoms such as lethargy and fatigue may occur in the early stages. The pain often occur before the formation of skin lesions, which usually follow two to three days later. Initially, small raised points (1) forms of the skin with redness. Within the reddened bodies formed to rice-sized, plump tense blisters (2), containing a clear liquid. Typically, this stage is complete after two to three days. The blisters fill with lymph then and break (3). Within two to seven days, the blisters then dry out. It forms on the affected skin a yellow-brown bark from (4). This phase can last one to four weeks, but usually the Zoster heals within two to three weeks from. Scarring occur frequently, especially if there is a second infection e. g. comes by bacteria.  In some cases, the rash can also be canceled altogether.
An occurring after healing of acute herpes zoster (postherpetic) neuralgia can sometimes occur due to nerve damage (5). The localization of shingles is determined by the supply area of the affected nerve. Mostly occurs zoster in the thoracic region of (intercostal nerves). Occasionally, back, arms or legs may be affected. In ophthalmic zoster face and eyes are affected (ophthalmic nerve in the trigeminal nerve). If the eyes are affected, partial or complete blindness can result by corneal scarring. For infection of the facial nerve (facial nerve) can cause temporary paralysis or loss of taste. Zoster oticus called an infestation of the ear canal and the outer ear or. Possible consequences are here with the zoster typical severe pain hearing (cochlear nerve) and disorders of balance (vestibular nerve). Left untreated can result in permanent hearing impairment or deafness. Zoster generalized satus called an infestation of the entire nervous system; this form of the disease is life-threatening, but usually occurs only at strong primary immune system suppression on (z. B. with AIDS, leukemia or other cancer types).
Zoster herpes occurs in the genital area. He takes over the genitals like the penis, labia, clitoris large area up to the thigh. In lymphatic drainage of the skin affected area often can be detected activated lymph nodes. complications Ophthalmic zoster in face and eye Herpes zoster complications are relatively common with about 20% of cases. In particular, post-herpetic neuralgia (PHN), also known as postherpetic neuralgia (PZN) referred, is very common and causes severe, often described as a burning pain. The PZN / PHN may even persist for life in the worst case and is unbearable for those affected to some extent. Such pain can the affected drive even to suicide.   The rarer forms zoster zoster as generalized satus, ophthalmic zoster (10-15%, of which have ocular involvement 30-40%) and zoster oticus will occasionally complications counted. Not infrequently heal the sores only pigmentation and scarring (Unlike chickenpox, provided that these have not led by scratching, scarring). Other complications are rare and usually affect only highly immunocompromised. Complications include zoster meningitis (meningitis), zoster encephalitis (Hirngewebsentzündung) and zoster myelitis (inflammation of the spinal cord).
Similarly, it is common to paralysis of peripheral nerves, in particular of the facial nerve. However, the form of paralysis usually back.  Diagnosis and differential diagnosis The herpes zoster is predominantly a diagnosis on the basis of clinical symptoms. Specific virus testing procedures are necessary only in complicated courses (involving the central nervous system, generalized zoster) or uncertain clinical signs. Is a leader in all cases of direct virus detection by PCR, either from the affected tissue or tissue fluid, or dotted bubble content. Since it is a reactivation, serological methods to detect specific antibodies are only very limited information. For reactivation of VZV, the anti-VZV-IgA may be detectable for several months at the same time a negative anti-VZV IgM. The differential diagnosis is to think in the occurrence of typical blisters on the skin and to an atypical localization of herpes simplex infection. This mimicking the shape of the Zoster Herpes simplex is also referred to as “Zosteriformer Herpes simplex”. Conversely, an irregular localized zoster as “Herpetiformer zoster” imitate a herpes simplex infection. Another possible cause of ever occurring again skin sores also a Hailey-Hailey disease is concerned.
therapy The varicella zoster virus can be treated with antivirals. Complications can only timely treatment, are the patients and physicians often incorrectly assessed prodromal reduced, so that this opportunity usually can not be used. It is important to early medical treatment with antivirals for very extensive findings, for example, involvement of the eye or ear, and especially with pre-existing immune deficiency (eg. , Tumor disease, severe diabetes mellitus or AIDS). Usually, the treatment with acyclovir, brivudine, famciclovir or valacyclovir, usually in tablet form. In more complicated cases (involving the eye, ear, spinal cord) intravenous treatment is necessary. Usually the addition of strong painkillers is displayed. At about eight percent of the patients, the acute pain can not be affected by pain relievers. Cases of post-herpetic neuralgia (about 30% of patients still have four to five weeks after the crusting diffuse (without recognizable contours) or locally (locally) limited, partly severe pain) are often difficult to treat. Come into consideration here with painkillers and antidepressants and neuroleptics, sometimes even surgery. Treatment with electrotherapy (galvanization, electrical stimulation or transcutaneous electrical nerve stimulation) can relieve pain. However, skin lesions have to be considered (vesicles and pustules).
Prevention / vaccination The highest for the patients responsibility to third parties is to avoid contact with pregnant women. Did this fact – particularly in the case of an unplanned “sudden” pregnancy – no corresponding vaccination obtained and otherwise no or insufficient antibodies to the virus in the body, a chickenpox infection during pregnancy can lead to developmental problems in children. In a chickenpox outbreak at the mother in the last days before the birth, there is even fatal injury to the child. The vaccine (Zostavax ™), which lowers the risk of disease preventively to about half, was approved on 25 May 2006 in the US by the competent authority FDA. On 25 October 2006 recommended the Advisory Committee on Immunization Practices (ACIP), which is part of the U. S. Centers for Disease Control and Prevention, the administration of the new vaccine to all persons older than 60 years.  In the Federal Republic of Germany a licensed from the first year of life varicella  is recommended by the Standing Committee on Vaccination as standard vaccine. With such a vaccination 51% of cases could be prevented and a PZN 66. 5% are avoided. If, despite vaccination, yet shingles occurs, it is usually more significantly milder and with fewer complications.
 References ↑ abGürtelrose shingles at gesundheit. de ↑ B. Ultsch et al . : Herpes zoster in Germany: Quantifying the burden of disease. BMC Infectious Diseases 2011, 11: 173 doi: 10. 1186 / 1471-2334-11-173 ↑ from Ingrid Moll: “Dermatology”, 6th edition, Stuttgart, 2005, p 215f ↑ vaccination against shingles ↑ U. S.
Panel Backs Shingles Vaccine ↑ recommendations of the Standing Committee on Vaccination (STIKO) at the Robert Koch-Institut / Date: July 2008, available in pdf; last accessed on 1 August 2009 short often referred ↑ The original study by Oxman and colleagues in the New England Journal of Medicine A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults as “Shingles prevention study” Web Links Please note the advice on health topics!
Varicella / zoster herpes – infection syn: varicella / chicken pox / varicella / CH: Spitzy Blattere HER / Rossi 446 / derm1 132 / HNO1 / Oph1 / Gyn1 Related topics zoster ophthalmicus zoster oticus Chickenpox / “Spitzi Blattere” General • Varicella zoster virus, herpes zoster virus syn ð neurotropic virus DNA persist.
respectively after primary infection in the ganglia of the dorsal nerve roots. sensory ganglia of the cranial nerves. • initial infection ð varicella • Reactivated infection ð Herpes Zoster to form • as rel. harmless childhood disease: O Chickenpox / Spitzy Blattere / Chicken Pox •
be teratogenic when non-immune mothers btw. SSW 8 and 21 is infected with VZV • ev. severe cases in newborns ï with peripartum infection (mother 2d forward to 5d after birth) • by reactivating the persist in the spinal ganglia. VZViren: O Zoster / Shingles O
in immunosuppressed patients often respectively bilaterally. spread over several dermatomes; this in opp to look at “immunocompetent” clinic • • • • • Zoster / Shingles ð usually limited strictly to one or two dermatomes in immunosuppressed patients often bilaterally and / or spread over several dermatomes! •
impetigo • herpes Simplex ï localization DD exanthemischer teething • rubella • measles • Dreitagefieber •
scarlet • chickenpox • varicella ð • Herpes Zoster ð ev ZosterOticus ð ev. postherpetic neuralgia • ev in immunosuppressed. Disseminierender Herpes therapy usually symptomatic:
Skincare (best drying + gg superinfection effective) eg Imazol (drying acts PLUS gg. fungi) • K: Imazol® eg Eau d’Alibour Analgesia (neuralgic Sz) carbamazepine e. g. • K: Tegretol® antiinflammatory drugs e. g.
• K: in immunosuppressed patients, the incidence of impetigo or older PE antibiotics for prophylaxis of superinfection systemically in immunosuppressed Aciclavir acyclovir e. g. 800mg po 5xtägl about 7d • K: Zovirax® famciclovir e. g. 500mg po 2-3x daily through 7d • K: Famvir®
Ansteckungsprophyllaxe ð Pregnant and immunocompromised must be absolutely protected against infection ! ! ! ð Health staff, including eg 1Week ON ausstellen4 ! ! ! Postexpositionelle Prophyllaxe • . U in pregnant immunosuppressed PE after exposure:
human zoster immunoglobulin iv • K: Varitect® • risk newborns: zus acyclovir. • K: Zovirax® Images Varicella / chickenpox Typical rashes in varicella: initially contained, fully partially watering rashes that dry and heal source M-WW source IndiaMart Healthcare source kinderarzt-moebus. de herpes zoster
Herpes lesions Dermatom Th Dermatom V1 typical vesicles source UniWichita source UniFlorida source histopathology source source sources course left •1
HER / derm1 132 / Rossi / HNO1 / Oph1 / Gyn1 • 2 BU gynecology SZBiel, Prof. Herrmann • 3 SKBU gynecology and Geb. Hilfe • 4 WSJ internal medicine Frutigen April. Mai. 04 • 5 BU Dermatology
began 11:05:03 updated: 5:05:04 broken links: x feedback signals via enamel herpes infections DermisNet emedicine pain clinic UniFlorida
herpes zoster DEFINISI Herpes Zoster (Shingles) adalah Suatu infeksi yang menyebabkan erupsi kulit yang sangat terasa nyeri berupa lepuhan yang Berisi Cairan. Herpes zoster bisa terjadi pada usia berapapun tetapi paling sering terjadi pada usia diatas 50 tahun. PENYEBAB Penyebab herpes zoster virus adalah varicella zoster virus-yang juga menyebabkan cacar air. Infeksi awal oleh virus varicella-zoster (yang bisa berupa cacar air) berakhir dengan masuknya virus ke dalam ganglia (badan saraf) pada saraf spinal maupun saraf kranialis dan virus menetap disana dalam keadaan tidak aktif. Herpes zoster selalu Terbatas pada penyebaran akar yang saraf terlibat di kulit (dermatome). Virus herpes zoster bisa tidak pernah menimbulkan gejala lagi bisa atau Kembali aktif beberapa tahun kemudian. Herpes zoster virus tejadi jika Kembali aktif. Kadang pengaktivan Kembali virus ini jika terjadi terdapat gangguan pada sistem kekebalan Akibat Suatu penyakit (misalnya karena AIDS atau penyakit Hodgkin) atau niobate obatan yang mempengaruhi sistem kekebalan. Yang sering terjadi adalah dari penyebab pengaktivan Kembali virus ini tidak diketahui. GEJALA
3-4 hari sebelum timbulnya herpes zoster, penderita MERASA tidak enak badan, menggigil, Demam, mual, Diare atau Sulit berkemih. Penderita lainnya hanya merasakan nyeri, kesemutan atau gatal di kulit yang terkena. Muncul sekumpulan lepuhan kecil Berisi Cairan dikelilingi oleh daerah kemerahan. Lepuhan ini hanya pada Terbatas daerah kulit yang dipersarafi oleh saraf yang terkena. Lepuhan paling sering Muncul di batang Tubuh dan hanya biasanya mengenai satu sisi (kanan saja atau kiri saja). Daerah yang terkena biasanya peka terhadap berbagai rangsangan (termasuk sentuhan yang sangat Ringan) dan bisa terasa sangat nyeri. Lepuhan Moulay quantitative ring dan membentuk keropeng pada hari kelima setelah Mereka Muncul. Lepuhan mengandung virus herpes zoster, yang bisa jika ditularkan menyebabkan cacar air. Lepuhan yang lua atau menetap Lebih dari 2 Minggu biasanya menunjukkan bahwa sistem kekebalan penderita tidak berfungsi sebagaimana mestinya. Suatu Serangan herpes zoster biasanya memberikan kekebalan yang cukup lama sebelum terjadi Serangan berikutnya; kurang dari 4% penderita yang mengalami Serangan Kedua. Sebagian besar penderita mengalami penyembuhan tanpa meninggalkan gejala sisa. Tetapi bisa terbentuk Jaringan parut yang luas meskipun tidak terjadi infeksi bakteri sekunder. Jika mengenai saraf Wajah yang bisa menuju ke mata menimbulkan masalah yang serius cukup.
Neuralgia pasca-herpetik Neuralgia pasca-herpetik adanya nyeri di daerh kulit yang dipersarafi oleh saraf yang terkena. Nyeri ini bisa menetap Selama beberapa bulan atau beberapa tahun setelah terjadinya Suatu episode herpes zoster. Nyeri bisa dirasakan Terus menerus atau hilang-Timbul dan bisa Semakin memburuk pada malam hari atau jika terkena panas maupun dingin. Nyeri paling sering dirasakan pada penderita usia Lanjut; 25-50% penderita yang berusia diatas 50% mengalami neuralgia pasca-herpetik. Tetapi hanya 10% dari seluruh penderita yang mengalami neuralgia pasca-herpetik. Pada sebagian besar kasus, nyeri akan menghilang dalam waktu 1-3 bulan; tetapi pada 10-20% kasus, nyeri menetap Selama Lebih dari 1 tahun dan jarang berlangsung sampai Lebih dari 10 tahun. Pada sebagian besar kasus, nyeri bersifat Ringan dan tidak memerlukan pengobatan Khusus. DIAGNOSA Diagnosis ditegakkan berdasarkan gejala-gejalanya yang mengikuti pola dermatome pada satu sisi Tubuh. PENGOBATAN Obat antivirus bisa untuk diberikan memperpendek lamanya erupsi kulit, terutama pada yang penderita mengalami gangguan sistem kekebalan. Sangat penting untuk menjaga kebersihan kulit agar tidak terjadi infeksi bakteri sekunder.
Aspirin atau bisa kodein meringankan nyeri untuk sementara waktu dan bisa jika diberikan rasa nyeri menyebabkan penderita tidak dapat tidur atau melakukan Aktivitas. Aspirin tidak boleh diberikan kepada anak-anak karena memiliki resiko terjadinya are roma Reye. SUMBER: Apotik online dan informasi media obat – penyakit :: m e d i c a s t o r e. c o m
Shingles – secondary, recurrent infection VZV. Clinic – herpes zoster. In contrast to the primary VZV infection – chickenpox. in AP in the clinical picture in the foreground is not so much as epiteliotropnye neurotropic properties of the virus. There gangliotegmentalnuyu, ganglionevralgicheskuyu, visceral and disseminated form of exhaust. zoster can Ganzliotezmentalnaya form of herpes in localized versions and distributed occur. The most common localized version, in which you can change the skin (or the mucosa) in a dermatome. Most patients with herpes zoster, involved the process the GVA ganglia, less lumbar (more Do-L segments) spine. The disease begins suddenly with the appearance of burning pain along the branches of the affected sensory nerve lesions at the site of the future, which continued for 3-4 days, and sometimes – 10-12 days. Often the pain is unbearable, worse at the slightest touch on the skin, while cooling, movement. Then there is hyperemia and infiltration of the skin of the affected area, against which the bubbles are formed, filled with clear content, first isolated and further there are more, grouping them to occupy a large surface of the skin. Serous content bubbles rapidly turbid, formed pustules that burst, dry up and turn into scabs. Epithelialization process is completed in 1-3 weeks.
Lesions are often accompanied by fever. Noise. Neurological pain is usually reduced with the advent of the rash, but there are some patients stay for several months or even years, because of the development ganglionitis, ganglionevrit. Less commonly observed with herpes zoster symptoms of trigeminal ganglion (gasserova node). The rash along the branches of the trigeminal nerve located – on the scalp, face, mucous membranes of the eyes and nose. Unilateral lesion of the skin and mucous membranes. Especially dangerous burst of bubbles in the cornea, which is accompanied by the phenomena of keratitis with subsequent scarring and vision problems. The defeat of the crank mechanism of the facial nerve by a rash on the ear and around it, accompanied in the ear canal. Designed with Ramsay Hunt syndrome can not only defeat the options of the outer ear and middle and even the inner ear are. In rare cases it can cause paralysis of the facial nerve. Trigeminal ganglia defeat and facial nerves are Syndrome by severe pain and noise. Against the background of immunodeficiency developed gangrenous (necrotic) form of the disease. Abundant merge bubbles quickly pustular, after the opening of which formed a crust covering the ulcer-necrotic changes in the skin.
Necrotic tissue is torn, so that the main shortcomings, the healing that takes place through long scars. Necrotizing form of Herpes zoster is an AIDS-defining illnesses and evidence of pronounced immunodeficiency. Immunodeficiency defined development and distribution options gangliotegmentalnoy form of herpes zoster if bubbles appear within two or more dermatomes or other distant areas of the skin and mucous membranes and are discreet, like chickenpox. Pain, skin rashes are in the area of innervation of the affected nerve differentiate disseminated herpes zoster with varicella grouped. This form of herpes zoster is commonly found in patients with lymphoblastic leukemia, acute leukemia, Hodgkin’s disease, and in patients receiving long-term, the fire-derivative, cytostatics he woos. Ganzlionevralzicheskaya form of herpes zoster (zona fruste “herpes zoster without”), characterized by the absence of lesions on the skin and mucous membranes. The most important manifestation of this form is associated painful symptoms with impaired sensory and motor disturbances caused ganglionitis and neuropathy. Diagnosis ganglionevralgicheskaya form is difficult, so that patients are often treated by neurologists, with etiologically unverified diagnosis of facial neuropathy, trigeminal nerve, intercostal neuralgia and other. If the visceral form of herpes zoster in the pathological process involved a usually two or internal organs. So, with the defeat of the trigeminal and facial nerve often develops meningoencephalitis. Therefore, if a patient with minimally expressed envelope and cerebral syndromes, a doctor, he should be hospitalized. allow lumbar puncture and examination of cerebrospinal fluid to confirm the diagnosis. In debilitated patients is very high chance of developing encephalitis and neuropathy of different localization.
Sometimes there are hepatitis, pneumonia, inflammation of the esophagus, prostatitis and defeat other urogenital organs. Widespread (VZV sepsis) form of herpes zoster is rare. Increased risk of this form of exposed persons with severe immune deficiency – blood diseases, cancer pathology, transplant organs, especially in the bone marrow of HIV / AIDS. The disease is characterized and accompanied by fever, intoxication and severe DIC lesion by multiple organ. The mortality in disseminated herpes zoster is 60%. Shingles usually occurs over 40 years in people at the factors that lead to immunosuppression – respiratory infections, sinusitis, overheating, hypothermia, dentistry, stress, etc. , and all other persons who have a reason for the development of immunodeficiency. Typically exhaust relapses are very rare (4%). Recurrence of herpes zoster in a patient requires a doctor to look tested for the cause of immunodeficiency, including HIV infection, especially if the patient is found young or other reasons. Diagnosis of herpes zoster not gangliotegmentalnoy in developed clinical forms of work. Errors occur in the early stages of the disease in developing fever, intoxication, severe pain. Such patients put different diagnoses, depending on the location of the pain (heart attack, angina, liver and renal colic, and others. ).
Diagnosis of visceral and disseminated forms are also very difficult, in the absence of the characteristic lesions of the skin and mucous membranes. Specific laboratory diagnosis techniques similar to those used varicella and herpes simplex. Treatment. Patients with severe forms of herpes zoster and reserving the hospital. Because they. A source of infection for non-immune people, hospitalization in an infectious hospital Professional aimed in the treatment on an outpatient basis with the exception of symptomatic therapy for pain relief, to prevent secondary infection of the vesicles, and so on. D From the first days of the disease prescribe antiviral drugs orally and topically (see. Categories “treating chickenpox” and “Treatment of Herpes Simplex”). Exciter used throughout the period of active infection to the appearance of rashes and scabs to stop. The possibility of using a given infection uzevira, lobucavir, brivudine, and cidofovir. Highly effective zoster in the topical treatment of herpes has Epigenes. An important role in the treatment of herpes zoster played by the pathogenetic and symptomatic therapy, used to control pain symptoms: carbamazepine (finlepsin), NSAIDs, analgesics Ganglioplegic, and a number of methods of physiotherapy and reflexology (Baralgin, Tramal and other .
). Doctors should warn patients about the purpose of exhaust GCS, including ointments. Treatment postzosternoy neuralgia (chronic zoster-associated pain) is very difficult. In addition to the developed by neurologists therapies (drugs, plasmapheresis, acupuncture, physiotherapy, etc . . ), an attempt to be to use antiherpethetical drugs in high doses long course, for example, acyclovir up to 4000 mg / day of 10-14 days. , If the results are not always sufficiently encouraging.
definition Recurrent manifestation of infection with the varicella-zoster virus by endogenous viral reactivation. Clinical characteristics Beginning with erythema and localized pain, then grouped vesicles on erythematous bases standing; Swelling of regional lymph nodes. Then convert the vesicles into pustules burst and desiccation. The skin manifestations are mostly unilaterally on a dermatome (that of posterior root of the spinal cord segment innervated skin area) is limited. Occasionally, prodromal symptoms, which manifest themselves as neuralgia in the area of the affected dermatome and constitutional disturbance. Total duration of the disease in 2-4 weeks. causes – Usually no immediate triggering causes Herpes Zoster lockable, – Increased incidence in patients with system diseases (haematological malignancies, tumors) and immunosuppression. – Herpes zoster among young people must be also think of immunodeficiency in a HIV infection. – As in herpetic lesions present infetiöses virus, people who have not had chickenpox, obtain contact with zoster varicella.
Age distribution The peak incidence 6th-7th Decade predilection – Thorakalsegmente (48%) – Zervikalsegmente (18%) – Trigeminal nerve (15%) – Lumbosakralsegmente (8%) Localization-related special ophthalmic zoster Often severe, gangrenous waveform with strong eyelid, contralateral edema, spreading to the conjunctiva and cornea (ophthalmic co-supervision needed) and nasal possible Zoster mandibular and maxillary Involvement of the oral mucosa possible zoster oticus
Infection of the inner ear with possible damage to the vestibulocochlear nerve (hearing loss, vertigo) and indirectly of the facial nerve (Bell’s palsy) [Ramsay-Hunt syndrome] Zoster sine herpete Neuralgia and proven reactivation of VZV but absence of skin lesions. complications – In severe cases hemorrhagic and necrotic lesions (healing with scarring) – Occurrence segment independent “aberrant bubbles” to the image of the “generalized zoster satus” (differential diagnosis: Varicella) – Occasional complaints from internal organs, sometimes motor deficits (5% of all patients) with paresis or flaccid Plegie – Postherpetic neuralgia (to 10% of patients) Definition: pain in Zosterareal that longer than 4 weeks holding.
There are three different herpes diseases with which we are dealing in homeopathic practice: Herpes zoster, herpes simplex type 1 ( “simple herpes”) and herpes simplex type 2 (genital herpes). Herpes zoster or shingles is actually not a true herpes, because it is caused by the varicella virus (the chickenpox triggers). Herpes type 1 and 2 are also false names. With “simple herpes” is herein referred to a definition’s sake, the usual form of herpes labialis and herpes on the face, which is relatively benign and was formerly called type. 1 The stubborn and aggressive form of herpes 1, which occurs in the genital area is, according to a genital herpes. All three forms can look outwardly identical. Herpes zoster / shingles Herpes zoster is a temporary self disease heals spontaneously and lasts usually no longer than three to four weeks at a primary outbreak. Homeopathy is extremely effective in the treatment of shingles. This is particularly true for the relief of pain in both acute and post-herpetic neuralgia of – nerve pain as a result of shingles (which are not limited in time and can last for months or years, if the lesion is already healed). Many patients – particularly the elderly – can not tolerate the traditional medical standard treatment or the conventional painkillers, therefore homeopathy can be a real boon. Shingles can also be a sign of a weakened immune system and should be the decisive for a thorough investigation to identify hidden tumors, AIDS, etc. .
Most, however, herpes zoster slight evil and does not require treatment, unless the symptoms are very pronounced. Therapeutic indications for the treatment of shingles What is here the homeopathy? If the herpes outbreak is aggressive or sensitive organs attacks, such as the eyes, so there is no way past a homeopathic treatment. What help is naturopathy? Accompanying measures (especially important if the symptoms are not so pronounced that a homeopathic treatment is justified) are: vitamin C (1000 mg daily. ); Lysine (500 mg, twice daily. ); are also recommended garlic capsules and shitake mushrooms. It is also recommended to refrain from nuts, chocolate, corn, barley and other cereals and dairy products. Local treatment with calendula or lemon balm cream may relieve. Tea tree oil should avoid it because it can interfere with the action of homeopathic medicines. The measures of conventional medicine The conventional treatment includes painkillers and acyclovir (Zovirax), impair the effectiveness of the homeopathic medicinal product which only in exceptional cases.
In post-herpetic neuralgia, many patients use conventional medicine strongly narcotic or even anticonvulsant medications such Tegretal which interfere with the homeopathic treatment much more. A look at the “Workshop” Here follows the example of two homeopathic main means of a series of candidate drugs for alleviating and curing the symptoms of herpes zoster. The agents act when the patient just developed these symptoms, which is a reflection of the specific symptoms of matching drug. Apis Main indications: one of the main means of shingles on the face, especially the left side of the face additional indications: The skin is red or pink, with strong burning pain. additional indications: There is a pronounced swelling of the face, especially around the eye. additional indications: Significant relief the patient experiences by cold applications Kalmia Main indications: post-herpetic neuralgia, which starts when the rash goes back additional indications: by twitching stitches or tearing, sharp stabbing pains Location: more often on the right side
Location: on the face, particularly the right side of the face is affected Location: shoulder, especially the right shoulder Location: hull, especially the right side Special feature: the affected limb extends down.
definition Herpes zoster (shingles) is a viral infection caused by a reactivation of the varicella (chickenpox) is caused. The rash occurs in the rule, particularly in the thoracic region. Here, the rash takes the form of a belt at (Zona = belt). It is a disease that affects mainly older people (aged 60) and persons with weakened immune systems. Herpes zoster is a common disease. One reason is that a large part of the population has Variezellen (chickenpox). Reactivation is possible at any time. We point out that in certain circumstances the children of Herpes Zoster may be affected. The disease can be carried out without a prior chickenpox disease. Thus, the child gets an immunization against chickenpox. Epidemiology – Throughout Germany about 320000-400000 people of herpes zoster (shingles) are affected.
– In France, more than 100,000 cases of herpes zoster are known. In the United States there are about 500,000. It is important to know that about 90% of people are suffering in childhood chickenpox (which is a prerequisite to developing herpes zoster). 20% of adults fall ill later on Herpes Zoster. – About one third of people aged 60 who develop zoster herpes, suffering from post-herpetic pain. This is a strong and unpleasant pain. From the age of 70, the number may increase to 50% of cases. causes Herpes zoster is a disease which is caused by a DNA virus called varicella-zoster (VZV). To suffer from this disease, the patient in childhood must have come with the chicken pox pathogen in contact. This is a reactivation of the chickenpox virus. The virus migrates to the nerve pathways along, and remains in an inactive mode. The following causes may be responsible for the reactivation:
– stress – Strong sunlight (on the beach, in the mountains, etc. ). – Serious health problem – A vulnerability of the immune system, especially for people who suffer from diseases of the immune system (e. g. AIDS). risk groups The following persons are among the groups at risk of herpes zoster disease: – People who are older than 50 years, some specialists suspect that all older people will suffer more than 85 years, once in their lives under shingles. ; – People with a vulnerable immune system. In this group are found as HIV / AIDS patients, people with cancer chemotherapy and all the people who are suffering from an immune disease;
– People who use medications such as corticosteroids or immunosuppressants. Please note that for an infection from Variezellen (chickenpox) is necessary in childhood. symptoms We distinguish a total of three different ligands phases of acute Herpes Zoster: infection In the first week of infection a direct contagion goes out by the patient. It is the acute phase of the disease (when the bubbles occur). However, the patient does not transmit herpes zoster, but the chickenpox (varicella virus). Pregnant women who have never contracted chickenpox should be extra careful and not to approach people with herpes zoster (during the acute phase). Read also complications of chickenpox in pregnant women. 1. Prodromalphase – Before the appearance of the rash In the first phase the following symptoms of herpes zoster may occur:
– Pain, tingling, burning pain of Neven (for example, a nerve along the thoracic region). The symptoms occur in a localized region of the body. – Sometimes there may be a slight fever and gastrointestinal symptoms. 2. Acute phase – During the eruption During the acute phase or the rash following symptoms are observed: – After about 2 to 3 days, small blisters develop on a red ground. This rash is formed only in certain parts of the body. In the beginning there is a clear liquid of bubbles, but darkens after a few days. Subsequently, form the vesicles a crust and eventually fall off. Until this cycle is complete, it may take 2 to 4 weeks. The rash occurs in the rule, particularly in the thoracic region. Here, the rash takes the form of a belt at (Zona means in ancient Greek Belt).
Herpes Zoster may also occur on the forehead, the cheeks, the face, the ears (zoster oticus), or around the eye area (Ophthalmology area). The most affected by the shingles zones and regions are the regions of the thorax (53% of cases), cervical (20%), trigeminal (15%) and the lumbosacral region (11%). In severely immunodepressed patients, such as HIV / AIDS patients, the affected area may appear diffuse. – Severe pain, sometimes unbearable pain in the region of rash occur. 3. postherpetic neuralgia – After rash – complications Herpes Zoster In some cases, herpes zoster can lead to complications. We speak of a post-herpetic neuralgia or post-herpetic pain (Zoster = shingles). This neuralgia (pain in the nerve) is a serious complication. This takes at least 1 month or several months. The complication arises as problematical in the elderly. Below are the typical symptoms of postherpetic neuralgia: – Pain, burning, burning in the area where the rash is.
– Permanent pain – Strong tenderness These complications of the disease can daily such as difficult sleeping or eating, and even in some cases lead to depression. It should be noted that, for a timely treatment the chances of curing the disease can be reached without complications. General note We note, in some cases, the symptoms of herpes zoster sometimes with those of an ordinary herpes disease (other viral infection) or appendicitis can be confused. diagnosis The diagnosis of a disease with herpes zoster (shingles) results from the anamnesis (medical history) of the patient. It can also be provided by the by the characteristic symptoms. In some cases, a pathogen must be. This is especially the case if the symptoms are not unique. Laboratory tests, which allow the identification of the virus are the PCR, ELISA, or immunofluorescence. complications The complications of herpes zoster disease can present itself as severe.
Particularly in the case of herpes zoster ophthalmicus, as risks to the cornea – the retina – nerve, etc. exist. In this case, a doctor should be consulted immediately. Herpes Zoster can also lead to post-herpetic neuralgia, which causes severe nerve pain. This is a deeply oppressive or smarting. When to doctor We recommend each patient a doctor immediately for a herpes suspected to consult zoster disease. It is extremely important as soon as possible to begin with an antiviral treatment, to achieve the maximum effect. When Herpes Zoster affects the eye area or pain occur, it is a medical emergency. treatment In case of illness of herpes zoster, it is extremely important as soon as possible to begin treatment. On optimal treatment is already after the first three days of the first signs. This measure helps to prevent complications that often occur in people over 50 years.
Below you will find all the treatments that may be prescribed by the attending physician. These treatments are effective against herpes zoster and the complications that may occur (for example, post-herpetic neuralgia). Treatments in a disease of Herpes Zoster – For the pain, antalgic agents such as Paracetamol, NSAIDs (Asperin, ibuprofen, . . . ), pain relievers such as morphine derivatives. – In order to prevent the multiplication of the viruses and to relieve the pain: aciclovir, valaciclovir, famciclovir, brivudine, etc. – To avoid pain and reduce the duration of symptoms: steroid. – Any antibiotics in topical form (cream, . . . ) to prevent bacterial superinfection.
Possible forms of treatment in case of complications (for example, post-herpetic neuralgia) for Herpes Zoster The usual drugs are usually anti-pain agents: – Acetaminophen or NSAIDs (ibuprofen, Asperin, etc. ) – Tricyclic antidepressant (such as amitriptyline) – Local anesthetics (drugs or patches on the basis of lidocaine) – Anti-epileptic drugs (e. g. , gabapentin) – Corticosteroids (for example, prednisone) – Opioids (codeine, morphine, . . .
) [Source of the proposed drugs: translated from English by Xavier Gruffat from the health side “webmd. com”, 2007} medicinal plants In case of illness of herpes zoster, a doctor must be consulted. Typically a drug treatment (antivirals) occurs. However, medicinal plants can serve the pain to ease, caused by the disease. – Cayenne pepper, which may be used in the form of a cream or a patch. – Aloe vera, which is used as a gel, to alleviate the pain. We also note that envelopes of clay for treating herpes zoster serve. Try it for yourself: natural medicines against herpes zoster. Essential Oils for the care of shingles Dilute in a tablespoon of alcohol at 45 degrees Celsius, 5 drops of the following essential oils: lemon, cypress, basil, geranium, lavender, rosemary, sage and thyme.
Soak with this mixture a compress and wear them 3 times a day for 10 minutes on the bubbles on. Note: This treatment should be started at the onset of pain immediately: pain and fever usually disappear within 24 hours. Perform the treatment after healing a few days away to avoid a relapse. aDVICE It is extremely important for suspected herpes zoster, to begin treatment as soon as possible and to consult a doctor. The earlier the treatment, the better the chances of a cure without the occurrence of serious complications. – Strengthen your defenses. This can be done with the use of Vitamin C. – Avoid stress. Namely, this is one of the triggers for herpes zoster. To prevent anti-stress courses can be carried out. This can help to reduce stress, and thus prevent development of Herpes Zoster. – If you suffer from herpes zoster, be sure to avoid any contact with pregnant women or immunocompromised individuals, who were not suffering from chickenpox.
The chickenpox can contribute to the deformity of the fetus and in general lead to health problems. – Upon the occurrence of severe itching (for example, during an acute phase of herpes zoster), which causes insomnia, an H1 antihistamines can be used. This is freely available in pharmacies and can be taken as a supplement to traditional treatment. prevention Herpes Zoster Vaccination An agent for the prevention of herpes zoster is vaccination, the preventive administration of acyclovir or immunotherapies. Prior vaccination worldwide – In the US, the herpes zoster vaccine will by the authorities strongly recommend that if you are older than 60 years old. – In France and in Switzerland, the vaccination is not specifically recommended. Vaccination means Zostavax®. To be more specific, the herpes zoster vaccination in Switzerland is not in the vaccination schedule (Status September 2013). The health authorities have decided that the benefit to public health is limited. They also inform that the chickenpox vaccine (Varilrix®) has no effect against herpes zoster, because the viral concentration for zoster prevention is insufficient.
– In England a large vaccination campaign was carried out, in which the over-70s against herpes zoster could be vaccinated. Information on vaccination A large study, “Shingles Prevention Study”, was carried out with 957 people suffering from herpes zoster. It showed that a reduction of the typical pain by 62% and postherpetic neuralgia of were achieved by 67% by the vaccine. How to translate Herpes Zoster in other languages?
Herpes zoster umumnya dialami para manula, terutama yang berusia di atas 50 tahun. Penyakit yang juga dengan dikenal istilah cacar api atau cacar ular ini disebabkan oleh virus yang sama dengan virus penyebab cacar air, yaitu varisela zoster. Virus varisela yang menetap di dalam Tubuh bahkan setelah cacar air sembuh, dapat Kembali aktif di kemudian hari dan menyebabkan herpes zoster. Penyakit ini tidak umumnya mengancam jiwa, tapi dapat menyebabkan rasa sakit yang parah. Karena itu, Segera hubungi dokter jika Anda merasakan gejala-gejalanya agar dapat ditangani sedini mungkin. Virus Penyebab Herpes Zoster Penyebab herpes zoster sama dengan cacar air, yaitu virus varisela zoster. Virus ini akan menetap dalam Jaringan saraf Tubuh bahkan setelah cacar air sembuh. Alasan di balik virus yang aktif Kembali belum diketahui Secara pasti. Tetapi ada beberapa faktor yang pemicu diduga memengaruhinya, yaitu: Uzziah. Penyakit ini umumnya menyerang manula (terutama yang berusia 50 tahun ke atas). Pernah mengidap cacar air.
Sistem kekebalan Tubuh yang menurun, misalnya karena mengidap diabetes, menggunakan obat steroid jangka panjang, atau menjalani kemoterapi. Mengalami stres. Pengidap herpes zoster tidak bisa menularkan penyakit ini pada orang lain, tapi dapat menularkan cacar air. Jika Anda belum pernah terkena cacar air dan mengalami kontak langsung dengan ruam Akibat herpes zoster, Anda dapat terinfeksi virus varisela zoster dan terkena cacar air. Jika terkena herpes zoster, gejala pertama yang akan dirasakan adalah rasa sakit. Rasa sakit ini juga bisa berupa sensasi terbakar. Beberapa hari kemudian, ruam menyerupai Setengah ling karan Muncul. Ruam ini biasanya mengelilingi sisi kiri atau kanan Tubuh, terutama pada perut dan dada. Ruam ini akan kemudian membentuk luka melepuh yang Berisi air yang terasa gatal dan Menjadi Koreng dalam hari 3-5. Meski begitu, gejala-gejala penyakit ini dapat bervariasi. Sebagian kecil pengidap mengalami rasa nyeri tapi tanpa ruam. Berikut adalah gejala-gejala lain yang dapat mungkin menyertai Kedua gejala utama di atas: Herpes zoster umumnya bukan penyakit yang serius dan tergolong mengancam jiwa.
Tetapi Anda sebaiknya Segera menghubungi dokter jika Anda pernah mende rita cacar air dan merasakan gejala-gejala di atas agar dapat ditangani sedini mungkin untuk menurunkan risk komplikasi. Langkah-langkah Mengobati Herpes Zoster Salah satu gejala herpes zoster berupa rasa nyeri dan ruam. Karena itu, diagnosis oleh dokter biasanya dilakukan dengan memeriksa Lokasi dan bentuk ruam, serta rasa nyeri dan gejala-gejala lain yang dirasakan. Dokter mungkin akan mengambil sampel kulit ruam atau Cairan dari ruam yang akan kemudian diperiksa di laboratory jika dibutuhkan. Sama seperti cacar air, tidak ada langkah Khusus untuk menangani herpes zoster. Tujuan pengobatannya adalah untuk mengurangi gejala sampai penyakit ini dengan sembuh sendirinya. Masa penyembuhan herpes zoster rata rata membutuhkan waktu 14-28 hari. Langkah pengobatan medis yang dapat dilakukan untuk mempercepat kesembuhan sekaligus mengurangi risk komplikasi adalah dengan pemberian obat antivirus. Contohnya, acyclovir dan famciclovir. Obat antivirus paling efektif jika diminum dalam tiga hari setelah ruam Muncul dan biasanya diberikan oleh dokter untuk digunakan pengidap Selama Maksimal 10 hari. Kelompok orang yang khususnya memerlukan obat antivirus meliputi manula dan orang dengan sistem kekebalan Tubuh yang seperti menurun pengidap kanker, HIV serta diabetes. Selain itu, antivirus juga pada diberikan pengidap dengan atau ruam nyeri yang parah dan jika herpes zoster berdampak pada mata.
Menangani rasa nyeri sedini mungkin juga dapat menghindarkan pengidap dari gangguan saraf yang dapat rasa menyebabkan nyeri berlangsung Selama berbulan-bulan bahkan bertahun-tahun setelah ruam sembuh. Untuk rasa mengatasi nyeri, ada beberapa jenis obat yang akan biasanya diberikan dokter. Di antaranya: Obat sakit pereda, misalnya acetaminophen, aspirin, ibuprofen dan codeine. Obat antikonvulsan, misalnya gabapentin. Obat antidepresan trisiklik (TCA), misalnya amitriptyline nortriptyline dan. Dokter biasa akan meningkatkan dose obat ini perlahan-Lahan sampai rasa nyeri dapat teratasi. Obat dan antikonvulsan antidepresan umumnya membutuhkan waktu beberapa Minggu sampai keefektifannya dapat dirasakan pengidap. Selain penanganan dengan obat-obatan, Anda juga dapat melakukan langkah-langkah Sederhana untuk mengurangi gejala yang Anda alami. Misalnya dengan mengenakan Pakaian berbahan lembut seperti katun serta menutup ruam agar tetap bersih dan kering untuk mengurangi iritasi dan risk infeksi. Tetapi hindari penggunaan Plester atau apa pun yang berbahan perekat agar tidak menambah iritasi. Jika ruam terasa gatal, Anda dapat menggunakan losion calamine untuk menguranginya. Tetapi hindarilah pemakaian antibiotik oles karena dapat memperlambat proses penyembuhan.
Sedangkan luka melepuh yang dapat berair dirawat dan dengan dibersihkan kompres air dingin. Mencegah Herpes Zoster Langkah pencegahan utama yang dapat dilakukan untuk menurunkan risk munculnya herpes zoster adalah dengan menerima vaksin herpes zoster serta cacar air. Walau tidak mencegah terkena herpes zoster sepenuhnya, setidaknya vaksinasi ini dapat mengurangi keparahan gejala yang akan dialami jika terserang penyakit ini. Anda juga dapat mencegah penyebaran penyakit ini dengan langkah Sederhana seperti tidak meminjam barang-barang Pribadi pengidap (misalnya handuk atau Pakaian). Jika Tidak Mengobati Herpes Zoster Jika tidak diobati, herpes zoster dapat menyebabkan beberapa komplikasi serius yang meliputi: Neuralgia pasca herpes atau postherpetic neuralgia. Rasa nyeri yang parah ini dapat berlangsung Selama berbulan-bulan bahkan bertahun-tahun setelah ruam sembuh. Diperkirakan ada sekitar 15 persen pengidap herpes zoster yang mengalami komplikasi ini. Kebutaan. Jika Muncul di sekitar mata, herpes zoster dapat mengakibatkan inflamasi saraf mata yang menyakitkan, glaucoma dan bahkan berujung pada kebutaan. Gangguan pada saraf, misalnya inflamasi pada otak, masalah pada atau pendengaran bahkan keseimbangan Tubuh.
Infeksi bakteri pada ruam. Bercak putih pada bekas ruam. Ruam herpes zoster dapat menyebabkan kerusakan pigmented kulit.
herpes zoster Shingles has a second name – herpes zoster. as a causative agent of herpes virus. The disease affects the nervous system and the skin, the treatment of both neurologists and dermatologists, depending on what the clinical manifestations are most pronounced, is performed. Shingles and chickenpox have a common etiology and pathogenesis. Diseases caused the herpes virus. Modern medicine called infectious, because they have a viral nature; Patients and virus carriers are highly contagious; very typical symptoms of infectious diseases consists of classic triad: The most common symptoms of infectious diseases, skin manifestations in the form of a characteristic of herpes zoster rash and manifestations of the central and peripheral nervous system. etiology The causative agent of herpes zoster and chicken pox is a virus of the family Herpesviridae. He, like all viruses of this family in the external environment is unstable and dies when exposed to sunlight, disinfectants and detergents, as well as with heating quickly. But at low temperatures is capable of a long time to maintain and is highly resistant to repeated freeze. Epidemiology pathogenesis
Shingles is a secondary infection of endogenous origin in patients who had previously undergone in clinical or latent form chickenpox. After chickenpox virus in the body for a long time remain, and is likely located in the dorsal root ganglia and in the ganglia of the cranial nerves and under the influence of provoking factors is the reactivation. Diagnostic and pathogenesis of certain latent forms of the disease is not well understood, but the reactivation of the virus and its clinical manifestations in the form of herpes zoster in the weakening of cell-mediated immunity. Stress, trauma, hypothermia, somatic and infectious diseases can also activate the virus. The proportion of incidence in people suffering from cancer, blood disorders or higher take hormonal and chemotherapy, as likely to develop with age, significantly increased. Pathology of the disease in its classical form is inflammatory changes in the dorsal root ganglia and in the surrounding areas of the skin, sometimes forward in the process and posterior horn of the gray matter of the spinal cord and roots involved such as the meninges. Clinic herpes zoster The disease begins gradually, common prodromal symptoms: headache, indigestion, a small rise in temperature, chills and malaise. Later, possible itching and burning of the skin at the site of the future eruptions associated pain and itching in the course of the peripheral nerves. These characteristics are subjective, and vary the intensity of the individual patient. The duration of the initial period of not more than 4 days, but the child time slightly shorter than that of adults. After a short prodromal period it has seen a sharp rise in temperature to febrile and intoxication symptoms (headache, muscle aches, loss of appetite). At the same time in the course of one or more dorsal root ganglia painful redness appear as pink spots that do not tend to merge with a diameter of 2-5 mm.
But during the day appear tesnosgruppirovannie vesicles with serous content in light of the rash. The edges of the vesicles unequal, based swollen and bloodshot. in Depending on the state of the immune system and the severity of shingles and pain increase in regional lymph nodes. Children can catarrhal inflammation of the upper respiratory tract (pharyngitis. Laryngitis. Rhinitis), exacerbation of the disease. Rash localized to the ground projection of the nerve root, as unilateral or bilateral disease of the nerve ganglia diagnosed. The most common sided lesion that is located along the intercostal nerve, trigeminal facial nerve. Cases where the affected nerve trunks of the extremities with the development of neuritis. It’s rare; Rash sometimes observed in the groin. When herpes zoster and varicella, at the same time you can see the different stages of rash see, starting and finishing from the spot areas hyperpigmentation after the dissolution of the vesicles. A few days later puffiness around the bubbles begins to decline, and with it, and flush the contents of the vesicles becomes turbid, they gradually dry up in their place serous crust after the fall of which is a light skin pigmentation formed. At the same time, the temperature, delivers the intensity of the noise syndrome and the end of the third week of recovery.
Generalized form. Sometimes a generalized form of herpes zoster is now confused with chickenpox, such as rashes, observed not only in the course of the nerve trunks, but also in other areas of the skin and mucous membranes. If diagnosed herpes generalized infection or disease is more than 3 weeks, the patient for the presence of immune deficiencies, and the presence of cancer procedure should be evaluated. Abortive form. When shingles occurs on the failed type, characteristic rash along the nerve trunks, which disappears quickly, without conversion into vesicles. not like the general condition of the patient. Bullous form. This form by larger vesicles that coalesce into large bubbles with serous content of herpes zoster. If the blood vessels are damaged, then content is hemorrhagic and accession infection – purulent. In severe cases, the bubbles merge into a continuous web, which can also be infected to dry, and to form a dark necrotic scabs on. The severity of this form depends on the location rash when the affected facial nerve. It joins the acute migraine, eyelids and corneal damage. Duration of the disease in the acute form – 2-3 weeks; if abortive – a few days; and in complicated or protracted course – more than a month.
The pain is burning, are paroxysmal in nature, and increases its intensity at night. Local paresthesias and sensory disorders of the skin and are the most common symptoms of herpes zoster. There are cases of violations of the oculomotor nerve, abdominal muscles and urinary sphincter. If you develop serous meningitis. the degree of change in the study of cerebrospinal fluid does not always correspond with meningeal symptom severity. In the acute phase of encephalitis and meningoencephalitis possible; Polyradiculoneuropathy and acute myelopathy occur in sporadic cases. After the treatment, and relapse occurs within a certain percentage of cases. Timely complex treatment of after-effects are not observed, but some patients neuralgic pains persist for several years. differential diagnosis The prodromal herpes zoster should be distinguished from pleurisy. Trigeminal neuralgia, and the syndrome of acute abdomen (appendicitis. Renal colic. Cholelithiasis).
If the rash is not removed along the nerve trunks, the differential diagnosis with herpes simplex. Varicella and bullous form must be distinguished in immunodeficiencies and diabetes of the faces and skin lesions on. Treatment of Herpes Zoster Causal therapy is the use of selective inhibitors of viral DNA synthesis – Acyclovir Zovirax, Viroleks. Such therapy is effective in the early stages of the disease. Acyclovir is administered intravenously, a daily dose of 15-30 mg / kg, which is divided in three doses at intervals of 8:00. A single dose is diluted in 150 ml of an isotonic solution. When using the tablet of acyclovir single dose of 800 mg, the drug to five times a day, the entire course of treatment – 5 days. Pathogenic therapy is to receive, which chimes 3 times daily rate of 5 to 7 days inhibits platelet aggregation 25-30 mg. Furosemide prescribed for dehydration. Thus immunogenesis activate shown intramuscular homologous immunoglobulin which is administered 2-3 times per day for 1-2 doses every day or two. Symptomatic treatment of herpes zoster associated individually, depending on the severity. Analgesics, antipyretics and restorative drugs, with insomnia – sedatives and opiates shown antidepressants in some cases.
If symptoms of intoxication pronounced, then held detoxification therapy with forced diuresis. Local vesicles with brilliant green and brown fat treated with 5% dermatolovuyu ointment. Solkoseril and metatsilovuyu ointment forms of herpes zoster used in low intensity. Locally, in the areas of the skin with rashes of herpes zoster, appoint a UFO. Quartz and laser therapy.
OLEH: ERFANDI 1. PENGERTIAN Herpes zoster adalah radang kulit yang acute bersifat khas seperti gerombolan vesicle unilaterally sesuai dengan dermatomanya (persyarafannya). Herpes zoster adalah sutau infeksi yang dialami oleh sesorang yang tidak mempunyai kekebalan terhadap varicella (misalnya seseorang yang tidak sebelumnya terinfeksi oleh varicella dalam bentuk cacar air). 2. ETIOLOGI Penyebab dari Herpes Zoster ini adalah Secara umum virus Varicella zoster. Varicella zoster virus adalah agens penyebab dari cacar air dan herpes zoster. Setelah sembuh dari cacar air, virus Varicella tetap ada dalam Tubuh dalam tahap laten seumur hidup. Sebagai virus laten, varicella tidak akan menunjukkan gejala Apapun, tetapi potensial untuk aktif Kembali. Pada tahap reaktivitas, Varicella zoster Muncul sebagai herpes yang sering disebut sebagai shingles. 3.
MANIFESTASI Klinis Adapun manifestasi Klinis yang sering terjadi pada herpes zoster adalah sebagai berikut: a. Adanya erupsi yang terlokalisasi hampir selalu unilateral dan pada Terbatas daerah kulit yang salah satu diinervasi oleh ganglion syaraf sensors. b. Gejala-gejala prodormalnya adalah: o Erupsi dimulai dengan adanya macula. o Pada stadium vesicle diberikan bedah untuk mencegah pecahnya vesicle agar tidak terjadi infeksi sekunder. o Bila terjadi ulserasi maka diberikan salep antibiotic. 6. PEMERIKSAAN PENUNJANG adapun pemeriksaan penunjang yang sering dilakukan adalah pemeriksaan pada yang vesicle berkelompok di atas eritema unilateral sesuai dengan matoma ganglion posterior. 7.
PATOFISIOLOGI Virus yang menyebabkan herpes zoster ini adalah golongan varicella yang mula-mula adalah dari penyebab cacar air atau yang sudah tidak varicella aktif atau dorman dan kemudian diaktifkan lagi oleh Tubuh. Herpes zoster virus herpes disebabkan oleh yang sama dengan virus penyebab varisella. Herpes zoster atau shingles, biasanya menyerang pasien yang berusia Lanjut. Virus varicella yang dorman atau tidak aktif, akan diaktifkan lagi dan Timbul vesicle-vesicle meradang unilateral di Sepanjang satu dermatome. Kulit di sekitarnya mengalami edema dan perdarahan. Keadaan ini biasanya didahului atau dengan rasa disertai nyeri hebat dan / atau dengan rasa disertai terbakar. Meskipun setiap syaraf dapat terkena, tetapi syaraf torakal, lumbar atau cranial agaknya paling sering terserang. Herpes zoster dapat berlangsung Selama kurang Lebih tiga Minggu. Rasa nyeri yang Timbul sesudah Serangan herpes neuralgia disebut posterpetika dan biasanya berlangsung beberapa bulan, bahkan Kadang-Kadang sampai beberapa tahun. Neuralgia posterpetika Lebih sering dialami pasien yang Lanjut usia. Jika herpes zoster menyerang ke seluruh Tubuh, paru-paru dan otak maka mungkin a can terjadi Suatu kefatalan. Penyebaran ini biasanya Tampak pada pasien mende rita limfoma atau leukemia.
Dengan demikian setiap pasien yang mende rita herpes zoster yang tersebar Harus dievaluasi kemungkinan adanya factor keganasan. 8. Perjalanan / POHON MASALAH
– Christian Hoffmann – A zoster is the reactivation of a previous infection with varicella (chickenpox), which persist for life in the dorsal root ganglia. Herpes zoster episodes are observed in HIV patients at relatively good immune status. Typical is the zoster under an IRIS, subsequent to starting ART (Martinez 1998). Patients are then often hard to convince them that the zoster is not necessarily a bad sign. With increasing immunodeficiency zoster tends to generalization. Besides the mere involvement of one or more dermatomes, dangerous investments of eye come (if lesions of the trigeminal nerve ophthalmic nerve “ophthalmic zoster” with participation of the cornea) in front and ear ( “zoster oticus”). Feared is the infection of the retina with necrotizing herpetic retinitis. The neurological complications also include a meningo-encephalitis, myelitis, but also the involvement of other cranial nerves as the trigeminal nerve (Brown 2001). clinic Often Prodromi exist with headache, malaise and photophobia that are rarely accompanied by fever. On the affected areas often consists initially only a hypersensitivity that goes within a few hours or days in itching and / or pain. The pain may precede the lesions few days.
These often appear as segmental (always one-sided! ) Redness with herpetiform bubbles in the range of one or more dermatomes. Lesions are ulcerating, often hemorrhagic, and dry up gradually. They should be kept clean and dry to prevent secondary bacterial infections. Me particular case of infestation of multiple dermatomes in about 20% back unpleasant pain syndromes. From such zoster neuralgia is assumed if the pain persist over a month (Gnann 2002). diagnostic In cutaneous infestation is usually sufficient visual diagnosis. In atypical localization (extremities! ) And complicated cases, the diagnosis can be misunderstood. Who is not sure then, may send a swab from a bubble in a viral culture in the laboratory. An immunofluorescence assay is believed to be more reliable. A VZV encephalitis is only detectable on CSF diagnostics or PCR.
When unilateral, occurring hyperacute hearing should be considered a zoster oticus which is not necessarily visible from the outside – either himself look into the ear or an ENT medical advice! For visual disturbances the same applies as with CMV retinitis – quickly to the eye doctor! therapy A monosegmental zoster can be treated on an outpatient basis with oral acyclovir. Important is a fast start. Systemic therapy is always required, and the dosages are higher than with HSV. A “Discuss the shingles” is permitted, but only with simultaneous antivirals. The drying of the lesions accelerates Zinkschüttelmixtur which also eases the pain. It put on the gloves! Initially, the lesions are highly infectious and unvaccinated people without varicella history, particularly pregnant women have to look at a herpes zoster nothing. With analgesics (Novalminsulfon, tramadol) should not be saved. Each complex, multisegmental or facial zoster is a case for the intravenous treatment, which can also be done on an outpatient basis with a good nursing service. As with HSV there with valacyclovir, famciclovir and brivudine alternatives to acyclovir.
In HIV-negative patients herpetic neuralgia are rarely caused by these substances than under acyclovir (Gnann 2002), but this is according to a recent Cochrane analysis inconclusive (Li 2009). Valacyclovir, famciclovir and brivudine have been, however, has hardly been tested on HIV patients, not allowed in immunosuppressed and up to € 120 / week considerably more expensive. Acyclovir resistance occur, but are rare (Gershon 2001 Saint-Leger 2001). In these cases may be treated with foscarnet. The treatment of zoster neuralgia is difficult. Carbamazepine or gabapentin help only partially, steroids are not useful (Gnann 2002). Since 2007, lidocaine (Versatis®) are approved in Europe, which are glued to the painful area. Due to possible local skin irritation, lesions should be healed. The effect often occurs only after days one (Garnock-Jones 2009). prophylaxis The varicella vaccine is contraindicated earlier, appears in more than 400 CD4 cells / mm to be safe and effective (Gershon 2001 Weinberg 2010). They should be considered in a negative VZV serology. With negative serology and varicella exposure (highly infectious!
) Can be given in individual cases hyperimmunoglobuline (i. v. 2 mg / kg). A time-primary prophylaxis is usually not advisable, a low-dose continuous therapy may be considered for persistent recurrences. Therapy / prophylaxis of VZV infection (daily doses) acute treatment Duration: At least 7 days 1st Choice acyclovir Aciclostad® 5 x 1 Tbl. 800 mg Severe cases Aciclovir ratiopharm p.
i. ® 3 x 1-2 Amp. 500 mg (3 x 10 mg / kg) i. v. alternatives valaciclovir Valtrex® 3 x 2 tablets. 500 mg alternatives famciclovir Famvir® 3 x 2 Tbl. Of 250 mg alternatives
brivudine Zostex® 1 x 1 Tbl. Of 125 mg prophylaxis Not recommended literature Brown M, Scarborough M, N Brink, Manji H, Miller R. Varicella zoster virus-associated neurological disease in HIV-infected patients. Int J STD AIDS 2001 12: 79-83. Garnock-Jones KP, Keating GM. Lidocaine 5% medicated plaster: a review of its use in postherpetic neuralgia. Drugs 2009, 69: 2149-65. Gershon AA.
Prevention and treatment of VZV infections in patients with HIV. Herpes 2001 8: 32-6. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med 2002 347: 340-6. Li Q, Chen N, Yang J, et al. Antiviral treatment for postherpetic neuralgia Preventing. Cochrane Database Syst Rev 2009; 2: CD006866. Martinez E, Gatell J, Moran Y, et al. High incidence of herpes zoster in patients with AIDS soon after therapy with protease inhibitors. Clin Infect Dis 1998, 27: 1510-3. Saint-Leger E, E Caumes, Breton G, et al.
Clinical and virologic characterization of acyclovir-resistant varicella zoster viruses isolated from 11 patients with AIDS. Clin Infect Dis 2001, 33: 2061-7. Weinberg A, Levin MJ, Macgregor RR. Safety and immunogenicity of a live attenuated varicella vaccine in VZV-seropositive HIV-infected adults. Hum Vaccin 2010 6: 318-21. Share this: