How to treat herpes zoster and what it looks like. Signs of shingles and methods of treatment

Content

Many people associate herpes with ordinary cold rashes, which, although they don’t look very pleasant, do not cause serious discomfort. However, this infection has many faces and one of its varieties is herpes zoster, characterized not only by damage to the skin, but also to the nervous system. The causative agent of shingles is varicella zoster or herpes zoster, which can be infected in early childhood.

What is shingles

In the ICD-10 classification of viral diseases, this disease is called herpes zoster. The disease is characterized by the appearance of skin rashes on the body or mucous membranes, damage to cells of the central and peripheral nervous system. Herpes zoster is often accompanied by nerve damage and severe pain. Anyone can become infected with the herpes virus, but most cases occur in people over 50 years of age.

Contagious or not

If a person had chickenpox as a child, his body has developed immunity to chickenpox pathogens, which reduces the chances of infection again to a minimum. For other patients, contact with sick people can trigger the occurrence of herpes zoster. Adults with low immunity especially often fall ill and older people suffer. Herpes zoster viruses are transmitted only at the time the characteristic rash appears, and during the period of wound healing it is not dangerous.

The causative agent of herpes zoster

Varicella zoster belongs to the family Herpesvididae, genus Poikilovirus. The pathogen organism has a round or slightly oblong shape with a core consisting of DNA cells. The virus is surrounded by a lipid-containing envelope. Once in the human body, varicella zoster provokes the development of a primary infection – chickenpox. After successful treatment, the virus does not die, but settles in the spinal cord, subsequently provoking relapses of the disease in the form of herpes zoster.

What does shingles look like?

When clinical symptoms appear, it is not difficult to recognize herpes zoster. At the initial stage, the disease is characterized by the appearance of many small bubbles with liquid. The localization of rashes is the sides, lower back, and abdomen. The appearance of a rash on the face, neck or ears is not so common. Areas affected by varicella zoster have an elongated shape, as if encircling the human body. This is where the name of the disease came from - herpes zoster.

Varicella-zoster virus - varieties

Herpes virus infection can have different clinical manifestations, especially in people with reduced immunity. Some patients may develop shingles on the face, others on the ears or eyes. In this regard, doctors have adopted the following classification of atypical manifestations of the virus:

• Ophthalmic herpes - characterized by severe lesions of the mucous membranes of the eyes, eyelids and branches of the trigeminal nerve.
• Ramsay-Hunt syndrome is a lesion of the facial nerves that leads to paralysis of the facial muscles. Characteristic symptoms: typical rashes in the oropharynx and ears.
• Lichen motor - expressed by muscle weakness, accompanied by damage to the neck or shoulders.
• Abortive herpes – characterized by the absence of foci of inflammation and pain.
• Hemorrhagic form - the patient may develop blisters with bloody contents, after healing of which scars remain.
• Bullous type of lichen - manifests itself in the form of large herpetic rashes with jagged edges.
• Gangrenous herpes - provokes tissue necrosis with subsequent scar formation.
• Disseminated lichen - herpes zoster affects the skin on both sides of the body.

Causes

The occurrence of herpes zoster is directly related to the childhood disease chickenpox. These diseases are caused by the same pathogen – varicella zoster. If you had chickenpox as a child, your risk of developing shingles increases. The thing is that the smallpox virus does not disappear after recovery, but hides in the nerve cells of the spinal cord. It can remain there for many years, but with a sharp decrease in immunity, it will awaken again.

The causes of herpes zoster may vary, but the main symptoms of herpes zoster appear when the body's immune response decreases. The following are at risk of infection:

• carrying out immunosuppressive therapy;
• HIV infection or AIDS;
• stress, depression, loss of strength;
• taking certain medications, such as immunosuppressants or antibiotics;
• chronic diseases of internal organs;
• oncological diseases;
• surgical intervention on the skin;
• consequences of radiation therapy.

Symptoms of the disease

The classic picture of herpes zoster begins with the appearance of severe shooting pain in the back, lower back or rib area. The victim feels general malaise, weakness, nausea, and sometimes the body temperature may rise slightly. After a few days, fuzzy pinkish spots appear in the areas of pain, and after about a day, blisters appear. Gradually they dry out, forming crusts. Infectious symptoms may vary slightly depending on the patient's condition and the stage of the disease.

Incubation period

Lasts no more than 3-5 days, during which signs of intoxication of the body appear. During this period, patients complain of severe headaches, chills and weakness. The functioning of the digestive tract may be disrupted, and appetite may disappear. A day or two after the virus is activated, pain appears in the nerve trunks and itching where rashes will subsequently appear.

Rash period

At the initial stage, small pink spots 3-5 mm in diameter with uneven edges appear. Then a herpetic rash appears in these places in the form of grouped serous blisters. You can notice infiltration and enlarged lymph nodes. In severe cases, the rash may contain blood clots. Sometimes the temperature rises up to 39 degrees.

Skin healing

At this stage of herpes, the blisters gradually rupture. The inflammation begins to dry out, redness and swelling disappear. In the place where the rash was previously localized, a crust appears, which goes away on its own. The temperature gradually returns to normal, and other symptoms of intoxication disappear. This period takes from 7 to 8 days, the total duration of the disease is 2.5-3 weeks.

Features of the manifestation of herpes zoster

If the immune system is functioning normally, symptoms of shingles may not appear at all. A person who has had chickenpox can live their entire life with the virus and never know about the diagnosis of herpes zoster. However, there are also opposite cases when the disease may recur or will occur with an atypical clinical picture. Features of the manifestation of herpes zoster in this case are presented in the table:

In what cases is hospitalization necessary?

Only patients with damage to the optic nerves, brain, or ear infections are subject to hospitalization. With such manifestations of herpetic infection, severe complications can occur: meningitis, blindness, trigeminal neuralgia. You should immediately consult a doctor if you experience a severe headache, loss of consciousness, muscle weakness, ear pain, convulsions, or high body temperature. Medical consultation is needed:

• if herpes appears in a newborn baby;
• during pregnancy or lactation;
• if characteristic rashes appear in elderly patients;
• patients with diabetes mellitus;
• with early diagnosis of cancer or while taking anticancer drugs;
• people with chronic heart, liver or kidney failure.

Treatment of herpes zoster

It is very important to start therapy in the first 2-3 days after skin rashes appear. This will prevent complications. Effective treatment cannot do without the use of antiviral drugs. To relieve pain, the doctor will prescribe analgesics. To boost immunity, immunomodulators are used, and to prevent herpes zoster, it is recommended to take vitamins A, E, and group B.

Antiviral drugs

The use of these medications helps to avoid the development of complications. Based on the general condition of the patient and the manifestation of infectious symptoms, the doctor will prescribe one antiviral agent. It could be:

• Famvir is prescribed as a course for a week at a dosage of 3 tablets per day. The medicine does not reduce pain and helps to avoid a severe neurological reaction.
• Valacyclovir is similar in principle to Famvir. Prescribed dosages of 2 tablets three times a day for a week.
• The drug Acyclovir is able to accelerate the processes of soft tissue regeneration. You need to take 4 tablets 5 times a day for 7 days.
• Valtrex – stops the reproduction of the virus. The course is prescribed for 7 days. The optimal dosage is 2 tablets three times a day.

Nonsteroidal anti-inflammatory drugs

This group of drugs has an analgesic effect, reduces inflammation, and works as an effective antipyretic. Herpes zoster should be treated with non-steroidal drugs after consultation with a doctor. Typically used:

• Ibuprofen is taken 1 tablet up to 4 times a day. The maximum course of treatment is 5 days.
• Diclofenac in tablet form should be taken 50-150 mg two to three times a day.
• Ketoprofen is initially taken in a loading dose of 300 mg per day with meals. During maintenance therapy, the dosage is reduced to 150 mg per day.
• Piroxicam in doses of 10 to 30 mg once.

Analgesics for pain relief

To relieve pain during treatment, the doctor may recommend local or systemic painkillers. For minor damage to the nervous system, the following are effective:

• Baralgin is a combined analgesic. Prescribed orally 1-2 tablets 2-3 times a day.
• Naproxen is available in the form of suspensions, rectal suppositories and tablets. Adults are prescribed 1 suppository at night or 500 mg tablets.
• Pentalgin is a combination drug. Take 1 tablet orally, without chewing, 1 time per day.
• Analgin - prescribed 0.25-0.5 grams 2-3 times a day. During treatment it is necessary to monitor blood counts.

Immunomodulators

During treatment, it is important not only to strictly follow the doctor’s recommendations, but also to increase the body’s defenses. To do this, doctors recommend normalizing nutrition. Eat more fresh vegetables and fruits, drink juices. In addition to a proper diet, immunomodulators may be prescribed:

• Cycloferon - 2 or 4 tablets in a regimen on days 1-2-4-6-8-11-14-17-20-23.
• Genferon - 500 IU twice a day for 10 days.
• Viferon in candles, 2 pieces in the morning and evening. The duration of treatment is 10 days.
• Galavit – 1 candle at night for 5 days.

Vitamin therapy

Doctors say that with age, natural changes in the gastrointestinal tract lead to the body less able to absorb vitamins A, C, group B and various minerals, and this is a serious blow to the immune system. To support the body during the recovery period, doctors recommend taking vitamin and mineral complexes according to the following scheme: 10-15 days of intake, then a break for 2 weeks and a new course of treatment.

Treatment of herpes zoster - concomitant therapy

As an addition to the main treatment, in consultation with the doctor, other methods of therapy can be used. Physiotherapeutic procedures improve blood circulation, relieve pain, and reduce pigmentation after removing the crust. A proper diet and taking interferons help strengthen the immune system. For the entire duration of treatment, the patient is prohibited from taking baths, visiting the pool, or in any other way moistening herpetic rashes.

Physiotherapeutic procedures

Physiotherapy helps get rid of many diseases and herpes zoster is no exception. The choice of a specific technique depends on the stage:

• If the disease occurs in an acute form, it is suggested:
  1. Magnetotherapy – the body is exposed to alternating high-frequency magnetic fields. Such procedures have an analgesic and anti-inflammatory effect and accelerate biochemical reactions in tissues. The minimum course is 10 procedures.
  2. Ultraviolet irradiation. Under the influence of UV rays, the zoster virus stops multiplying. This therapy improves immunity and speeds up recovery. For complete recovery you need to undergo 5 sessions.
• At the regression stage they offer:
  1. Amplipulse therapy - the technique involves the use of low-frequency sinusoidal currents. Sessions help speed up cell regeneration, relieve swelling and inflammation.

Local treatment

Therapy using aerosols, gels or antiviral ointments is prescribed only as part of a comprehensive treatment of herpes. As individual drugs, such drugs are ineffective. External means used:

• Alpizarin ointment - has an antibacterial and anti-inflammatory effect.
• Eperduvin – has a good antiviral effect, stops the number of rashes.
• Brilliant solution, castellan - dries the bubbles and has an antimicrobial effect.

Diet food

American scientists have found that if you consume 1 gram of lysine every day, the number of relapses of herpesvirus infection will decrease by almost 2.5 times. Cottage cheese, milk, yogurt and other dairy products will help provide the body with this antiviral amino acid. Fish, meat and eggs are rich in lysine. Slightly less amino acid is found in legumes, dried apricots and cereals. At the same time, during treatment it is advisable to avoid foods containing arginine - chocolate, bread and other baked goods made from wheat flour.

Interferons

Ointments or aerosols based on interferons help build a strong preventive barrier to protect against herpes. Essentially, interferons are proteins that can reduce the amount of virus in a person’s blood. There are many drugs based on these substances. Many of them are available in tablets and are called immunomodulators, but interferons can be used in the form of an ointment or aerosol to complement the main antiviral therapy. These are drugs with trade names:

• Eridin;
• Zostevir;
• Helepin;
• Florenvl;
• Alpizarin.

Prevention methods

If treatment is started in a timely manner and all instructions and recommendations of the doctor are followed, herpes zoster does not cause complications. The main thing is that at the first suspicion or when characteristic symptoms appear, immediately consult a doctor and get a diagnosis. However, rather than undergo treatment and take a bunch of pills, it is better to prevent the development of herpes in advance. There are two main ways to do this: vaccination and immune stimulation.

Vaccination

Today there is only one vaccine against this type of herpes. It was created on the basis of an artificially grown Varicella-zoster virus. The solution, called Zostavax, is administered subcutaneously once. The duration of the therapeutic effect varies from three to five years. However, not everyone can get the injection. The vaccine is contraindicated for:

• pregnancy;
• diseases HIV or AIDS;
• presence of allergies to components;
Herpes zoster and how to protect yourself from it

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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Herpes type 3 (Herpes Zoster) is a common type. A similar disease in medical practice is called the varicella zoster virus or Varicella Zoster virus. The disease can only affect a person once, but the pathogen is integrated into the DNA structure and will remain there until the end of life.

Herpes type 3 (Zoster virus) is a disease of infectious origin that affects the central nervous system and peripheral nervous system, skin and mucous membranes.

This disease is characterized by a unilateral manifestation of the rash on the torso and face, associated with severe pain.

The viral agent enters the human body through airborne droplets, and if it is a child, he or she develops chickenpox. Having been ill, a person will be a carrier of the pathogen for the rest of his life, with its concentration inside the cells of the nervous tissue.

Pathways and mechanisms of transmission of herpes type 3

Herpesvirus 3, entering the human body, first causes the formation of a disease such as chickenpox. After recovery, this pathogen will not disappear, but will remain in the nerve cells of the spinal cord nodes and can remain there for years and not manifest itself in any way. But under the influence of negative conditions, it leaves the state of rest and can be expressed as quality.

At the moment, the exact reason that causes the awakening of the pathogen has not been established. However, it is known that one of the main factors that increases the likelihood of revival of a viral agent is weakened immunity.

There are various known factors that influence the formation of herpes zoster:

• immunosuppression (for example, or AIDS), implementation of immunosuppressive treatment;
• constant stressful situations;
• use of immunosuppressants (drugs that lower immunity);
• constant diseases of various organs;
• cancer;
• complications after radiotherapy;
• surgical interventions on the skin.

Routes of transmission of the virus

Often, the Zoster virus enters the human body through airborne droplets, and in rare cases – by contact. Viral agents can enter cells through the cell membrane, and then the reproduction stage begins.

What diseases does Varicella-Zoster cause?

In the process of damage to the ophthalmic nerve, the patient develops the following diseases:

1. . Damages the eye cornea. First, intense pain appears, and then vision decreases greatly. Redness and swelling occur. The patient complains of excessive lacrimation.
2. . This disease causes damage to the conjunctiva. Painful discomfort of a neurological nature appears. Afterwards, the blood vessels dilate, which can cause redness and inflammation. Often occurs in childhood.
3. Herpetic blepharitis. The eyelid is damaged, and a rash is observed on the skin near the eye. High photosensitivity appears.

The ear form is characterized by the formation of Ramsay Hunt syndrome, which manifests itself in situations where herpes zoster damages the facial nerve. Because of this, paralysis of facial muscles occurs, and pathological changes in the oral cavity and ear are noted.

The following changes are observed in the damaged area of ​​the patient’s face:

• a painful rash on or in the ear;
• intense pain in the ear;
• hearing loss;
• loss of taste;
• dizzy;
• the absence of wrinkles is noted on the forehead;
• lowered eyebrow.

Nature of the clinical picture

When a child’s body is infected, the following symptoms appear:

• , chills;
• rash on the skin as vesicles;
• intense skin itching.

Often in children, the Varicella Zoster virus becomes inactive and concentrates inside the cells of the nerve tissue.

Chickenpox is one of the most popular childhood diseases - more than 4 million cases of the disease are recorded every year. It is characterized by a long-lasting infection - primary symptoms appear 2-3 weeks after infection. The child's temperature rises, and after 2 hours slight pink spots appear on the body. Initially, the rash covers the body and limbs, after which the tubercles move to the head and mucous membranes.

A clear sign of chickenpox is a polymorphic rash, which is accompanied by severe itching. At the same time, the following is observed on the surface of the body:

• papules;
• vesicles;
• pustules;
• erosion (appears after ulceration of ulcers);
• crusts.

Shingles, which is also defined as herpes zoster or herpes zoster, is a disease in which the skin is affected, and the lesion is more pronounced and massive in appearance than the traditional version of herpes of the lips. Shingles, which can affect both men and women, is particularly common in people over the age of fifty, although it may occur in younger people.

general description

Shingles is a sporadic disease and manifests itself due to the activation in a person of the chickenpox virus, which is in a latent (that is, temporarily hidden) state in his body. With this type of herpes, the dorsal roots of the spinal cord and intervertebral ganglia are subject to inflammation, which is also accompanied by symptoms in the form of general intoxication, fever and a specific type of exanthema that forms along the course of the sensory nerves involved in this process.

Based on the features described above, we note that herpes zoster occurs in those individuals who have previously had chickenpox. The causative agent of both diseases is the same virus, Herpesviridae. It is noteworthy that it is unstable in relation to the influence of environmental conditions on it, and therefore quickly dies as a result of heating, the use of disinfectants and ultraviolet rays. Meanwhile, it also has the ability to maintain viability for a long time at low temperatures, and can, in addition, withstand repeated freezing.

Quite often, herpes zoster appears in patients exposed to various types of influences that affect the immune system. These include leukemia, neoplasms, chemotherapy procedures, long-term use of immunosuppressants and corticosteroids.

The development of this infection is especially common in people with HIV. As for older people, who are most susceptible to herpes zoster, here, as in the conditions previously listed, a decrease in immunity is also relevant, which acts as the most suitable basis for the disease.

With herpes zoster, as we have already noted, the smallpox virus is activated in a latent form, and the virus can persist for several decades, respectively, without showing itself in any way in terms of any symptoms. It is noteworthy that the virus can also involve the autonomic ganglia in the inflammatory process, and meningoencephalitis can develop. In addition, internal organs may also be affected.

Herpes zoster: principles of disease development

Herpes zoster: main forms of the disease

Clinical forms of herpes zoster can be as follows:

• gangliocutaneous form;
• eye and ear forms;
• necrotic form (gangrenous);
• a form of herpes zoster when it affects the autonomic ganglia;
• meningoencephalitic form;
• disseminated form;
• abortive form.

We will consider all these forms of herpes zoster and the symptoms characteristic of their course below, but first we will consider the main type of course of this disease.

Shingles: symptoms

The duration of the incubation period determined for this disease is the period from the moment the patient suffered the primary infection until its activation, which, in turn, can last many years.

The initial period of herpes zoster is characterized by the presence of so-called prodromal signs, which manifests itself in the form of headache and general malaise, an increase in temperature to subfebrile levels (up to 38 degrees), and the appearance of dyspeptic disorders (that is, digestive disorders).

Simultaneously with these manifestations, burning, pain and itching also occur in combination with severe tingling and paresthesia (a feeling of numbness), concentrated along the course of the peripheral nerve trunks in the area where the rash will subsequently appear. As for the intensity of the listed symptoms, it is individual in each case.

The duration of the initial period of herpes zoster can range from 1 to 4 days, while in adults it is observed more often than in children.

In the vast majority of clinical cases, shingles begins acutely. This implies an increase in body temperature of about 39 degrees, which is accompanied by the addition of general toxic reactions (in the form of chills, general malaise and headache). At the same time, the zone of innervation of the spinal ganglia (one or more of them) becomes covered with characteristic skin rashes, the appearance of which is also accompanied by certain sensations (pain, numbness, etc.).

The initially appearing exanthema looks like limited pink spots, their size is about 2-5mm. Meanwhile, on the day of appearance or by the next day after that, small vesicles appear against their background, closely grouped with each other, they contain transparent contents. Often the appearance of exanthema is accompanied by pain and enlargement of the lymph nodes.

The localization of the exanthema is determined based on the projection of the corresponding sensory nerve. Mostly, such a lesion is unilateral, focusing along the course of the intercostal nerves, along the branches of the trigeminal nerve located on the face, and also, which is not so often noted, along the course of the nerves concentrated in the extremities. In addition, some cases of the disease in practice indicate the possibility of skin lesions of the genital organs.

The course of herpes zoster may be accompanied by the formation of new spots, which occurs at intervals of several days; against their background, vesicular formations subsequently develop. A few days after the appearance of these formations, the erythematous background, which serves as the basis for the location of the vesicles, becomes pale, and the contents of the vesicles themselves become cloudy.

Later, they begin to gradually dry out, which is accompanied by the formation of crusts; they, in turn, begin to disappear by the end of the third week of the disease. Ultimately, slight pigmentation remains on the skin at the site of their location.

As for the phenomenon of elevated temperature with herpes zoster, it persists for several days, subsequently returning to normal, and the rest of the symptoms also disappear.

Shingles: symptoms of main forms

The most common form of the disease we are considering is gangliocutaneous form . It is characterized by an acute onset in combination with fever and symptoms of intoxication. In addition, sharp pain also appears in those areas where skin rashes relevant to the disease will subsequently appear. After about four days (and in some cases about 12), the rash itself appears. The concentration of pain and rashes is determined by the area of ​​the affected nerves (the intercostal nerves are predominantly affected), the nature of these manifestations corresponds to the name of the disease itself - that is, in this case it is shingles.

In some variants of the course of the disease in this form, pain sensations become simply unbearable for patients, and their intensification can occur even with a slight impact on the skin (movement, cooling) or with a light touch. In the place where the vesicular rash subsequently appears, skin infiltration and hyperemia are initially noted, that is, abnormal seepage of the infiltrate into the skin with its redness occurs. After this, bubbles with transparent and subsequently cloudy contents form in a grouped manner. Further, the course of the disease is characterized by the drying of these bubbles and their transformation into crusts.

It also happens that the disease in this form occurs with symptoms of intoxication and pain, but without the appearance of a rash. Meanwhile, if a rash does appear, it brings some relief to the patient, because the pain in this case is less pronounced.

Ear and eye shapes herpes zoster also have symptoms characteristic of each of them.

So, eye shape is accompanied by damage to the trigeminal ganglion (which is also defined as the Gasserian ganglion), as well as localization of disease-relevant rashes along the course of the trigeminal nerve, that is, on the face, nose and eyes.

Concerning ear shape, then its course is characterized by the involvement of the geniculate node in the process, as well as the appearance of rashes directly on the auricle, as well as on the skin surrounding it. In addition, rashes can be concentrated within the area of ​​the external auditory canal. The possibility of developing facial paralysis cannot be ruled out. The appearance of a rash in this form of the disease is preceded by symptoms characteristic of fever and general intoxication.

The duration of trigeminal neuralgia can be on the order of several weeks, and it is characterized by the general severity of its manifestations. The ocular form of herpes zoster can also be accompanied by viral keratitis; iritis and glaucoma develop somewhat less frequently.

Necrotic form of herpes zoster (also known as gangrenous) occurs, as a rule, in weakened patients. It is characterized by deep damage to the skin, which subsequently leaves scars. In this case, there is reason to assume that the layering provided by the bacterial infection plays an important role in the specific course of this form of the disease.

Quite rarely observed in practice meningoencephalitic form herpes zoster. It is characterized by an extremely severe course, with death occurring in about 60% of cases. The onset is accompanied by the manifestation of symptoms of the gangliocutaneous form; as a rule, the area of ​​the intercostal nerves is affected, and, somewhat less frequently, the area of ​​the cervical spine. The subsequent development of the disease is characterized by the addition of meningoencephalitic symptoms. In particular, this includes the following manifestations:

• ataxia (disorder of coordination in voluntary movements);
• hemiplegia (absolute loss of the ability to perform voluntary movements of the limbs on one side of the body);
• hallucinations;
• meningeal symptoms - symptoms indicating irritation of the meninges (stiffness of the neck muscles, leading to difficulty in passive flexion of the head; Kernig's syndrome, in which it is impossible to fully flex the leg at the knee joint when it is bent at a right angle at the knee and hip joints; intolerance to touching the skin , sounds, bright light; reactive pain when certain areas are compressed);
• development of coma.

From the moment the rash appears relevant to the disease until the development of subsequent encephalopathy, it usually takes about two days to three weeks.

Generalized form. In some cases, several days after the formation of a clearly localized exanthema, single and sometimes multiple vesicles can form, and they can appear on a wide variety of areas of the skin (mucous membranes are not excluded). Such a course, in turn, can be mistakenly identified as chickenpox associated with herpes zoster. The generalized course of the disease, as well as the lack of results in the treatment of herpes, after 2-3 weeks determines the grounds for assuming that the patient will develop immunodeficiency or neoplasms of a malignant nature.

Concerning abortive form, then its main features are the rapid disappearance of the rash, as well as the absence of vesicles during the course of the disease. The clinical manifestations of this form of the disease last about several days; if we are talking about its acute course, then the period increases to two to three weeks, and if it is a protracted course, then up to a month or more.

For any of the forms discussed in this section, the possibility of the addition of such a symptom as damage to the autonomic ganglia is not excluded, which, in turn, determines the possibility of the appearance of symptoms unusual for herpes zoster (diarrhea, constipation, urinary retention, Horner's syndrome, various vasomotor disorders) .

As for the severity of the disease, it is often determined by its connection with the immediate area of ​​localization of the exanthems. So, if the rashes are concentrated in the area of ​​the nasociliary, frontal or supraorbital nerves, then the symptoms of herpes zoster in such cases are supplemented by neuralgic pain, damage to the eyelids, swelling and redness of the skin, and in some cases the cornea of ​​the eye is also affected.

It would not be amiss to consider the nature of the pain with herpes zoster, which, as we have already noted, is concentrated in the area of ​​​​the subsequent appearance of exanthems. So, the pain in this case is burning and paroxysmal, its intensification is noted at night, which often occurs in combination with pronounced emotional manifestations. In frequent cases, local paresthesia occurs (numbness, tingling of the skin), and disorders of skin sensitivity are also common.

In addition, the possibility of the appearance of radicular paresis (which implies a weakening in voluntary movements) of the areas of the oculomotor and facial nerves, abdominal muscles and limbs, as well as the sphincter of the bladder area cannot be excluded.

In addition to the listed features, herpes zoster can be combined with serous meningitis that develops against its background, while actual inflammatory changes occurring in the cerebrospinal fluid (cerebrospinal fluid) are in rare cases accompanied by meningeal symptoms. It is extremely rare that the acute period of herpes zoster is accompanied by the development of encephalitis and meningoencephalitis.

Herpes zoster is much more severe in cases of HIV infection or other immunodeficiencies. In these cases, the duration of the period before the appearance of rashes increases to one week; drying of the crusts, as one of the stages of the disease, occurs no earlier than after three weeks.

The greatest risk of developing herpes zoster in a progressive form is relevant for patients diagnosed with lymphoma or lymphogranulomatosis. So, about 40% of patients in this case are faced with the appearance of a rash that spreads along the surface of the skin throughout the body. Up to 10% of patients, along with disseminated (widespread) manifestations of skin lesions, are faced with the development of meningoencephalitis, viral pneumonia, hepatitis and other severe complications.

After the first episode of shingles, a stable remission usually occurs. As for the recurrence of this disease, it is observed extremely rarely (on the order of a few percent). In the vast majority of cases, recovery of patients occurs without any residual manifestations of the disease, although pain in the area of ​​the actual lesion may persist for a long period of time (from several months to several years).

Diagnosis

Often, clinical symptoms are the basis for establishing an appropriate diagnosis. The initial period of the disease is often accompanied, however, by an erroneous diagnosis, which is based on conclusions related to its primary symptoms (intoxication, pain, fever). The diagnosis in this case can be established in such a way as pulmonary infarction, pleurisy, angina pectoris, acute appendicitis, etc.

Differentiation is made from diseases such as herpes simplex, acute eczema, and erysipelas. To diagnose a generalized form of the disease, differentiation is required from a disease such as chickenpox.

In some cases, it is possible for a doctor to remove samples of tissue and the contents of formations for a more complete study. It is mandatory to take a blood test for HIV, because shingles can act as the only marker indicating the presence of this disease.

Treatment

Both the features of the course of herpes zoster and its outcome are determined based on how quickly the patient sought medical help. In particular, treatment is based on the use of ointments, antiviral drugs, non-steroidal anti-inflammatory drugs, and immunomodulators. Vitamin therapy and physiotherapeutic treatment using quartz are also used.

Treatment of shingles requires avoiding bathing and alcohol. Vitamin C-rich foods (citrus fruits, cranberries, etc.) are recommended. Treatment of herpes zoster with folk remedies should be carried out only in combination with treatment determined by a doctor, and, as a rule, folk remedies are focused mostly on increasing immunity and suppressing pain. The prognosis for herpes zoster is generally favorable, but this is true for all forms with the exception of the encephalitic form.

If you suspect shingles, you should seek advice from specialists such as an infectious disease specialist and a neurologist.

Herpes zoster is an extremely unpleasant and fairly common disease of a viral nature. Symptoms of the disease appear in different parts of the body. Usually this is the face, limbs, genitals, lumbar back. Sometimes rashes form on other areas of the skin, but most often on the face. This disease also has signs of damage to the nervous system. In addition to shingles, the causative agent of the disease - varicella zoster - can lead to the appearance of chickenpox in children, as well as adults who have not previously suffered from this disease.

Herpes zoster: causes of the disease

As noted, the appearance of herpes is caused by the Herpesvirus Varicellae virus. The properties of this pathogenic microorganism are similar to the characteristics and characteristics of other representatives of the family of viruses in question.

Firstly, the causative agent of herpes zoster does not tolerate various aggressive external influences well, or does not tolerate them at all. Thus, the virus dies even with short-term (up to 10 minutes) heating, under the influence of ultraviolet rays, disinfectants and special preparations.

Secondly, the causative agent of herpes zoster normally resists cold. Even with repeated freezing, this microorganism does not lose its harmful properties.

Most often, herpes zoster occurs in older people.

The peculiarities of the virus are such that the symptoms of herpes zoster will appear in the patient only if he has previously had chickenpox in its latent or typical form. No epidemic outbreaks of the disease have been recorded - cases of the disease remain exclusively at a sporadic level.

Most often, herpes zoster occurs in elderly patients, but cases of the disease developing in young people are periodically observed.

By its nature, the causative agent of the disease in question is a contagious infection. So, if a child who has not previously had chickenpox comes into contact with a carrier of the virus, after a certain time (usually up to 3 weeks) he will most likely develop chickenpox.

Thus, the shingles virus is a contagious disease and is transmitted by airborne droplets.

People who have previously had chickenpox retain a certain amount of the causative viruses in their bodies. A confluence of various unfavorable circumstances can lead to their awakening. As a result, inflammation will develop in places where pathogenic microorganisms are localized, with the manifestation of all the symptoms characteristic of this.

Among the key reasons that can lead to the awakening of the dormant herpes zoster pathogen, the following should be noted:

• nervous overstrain;
• deterioration of immunity under the influence of various types of chronic and acute diseases, including HIV and AIDS;
• hypothermia;
• injuries;
• neoplasms in the body, etc.

Symptoms of herpes zoster

Herpes zoster has a whole list of severe symptoms. The patient must be able to notice them in a timely manner and seek medical help as quickly as possible, because the sooner the specialist receives all the information he needs during the medical history and examination of the patient, the faster and more effective the treatment will be.

The patient begins to have a headache, weakness appears, the temperature rises to 37...38°C, and chills are often noted.

Signs of dyspeptic disorders may also be added to the symptoms described above. Discomfort, itching, burning and painful feelings often appear in the areas where the rash appears. The reason is that, before manifesting itself on the skin, the virus affects the patient’s nerve endings. Because of this, unpleasant sensations arise.

At a later stage, body temperature rises to 39°C. The patient has symptoms of intoxication. Rashes characteristic of herpes zoster form on different parts of the skin. First, the skin becomes covered with pink spots with an average diameter of 0.5 cm; after a couple of days, groups of bubbles filled with colorless liquid appear on the redness.

As a rule, skin manifestations of the disease are unilateral and most often localized on the face and in the intercostal space.

Sometimes there are cases in which rashes appear in the area of ​​the limbs and genitals.

In parallel with the appearance of rashes, regional lymph nodes enlarge. As their size changes, painful sensations appear.

After a few days, the tone of the rash becomes less bright, and the blisters themselves dry out and crust over. These crusts dry out completely and disappear within a month. The intensity of signs of intoxication decreases with decreasing temperature.

The above symptoms are typical for the typical form of shingles, but there may be other options, namely:

1. Abortive form: after the appearance of the papule, rapid regression of the rash is noted. In this case, the patient does not go through the bubble stage.
2. Bullous form: the vesicles coalesce, resulting in large blisters on the skin.
3. Generalized form: vesicles begin to spread throughout the mucous membranes and skin. Most often, this scenario for the development of the disease is typical for HIV-infected patients.

As a rule, after the disease subsides, a period of stable remission begins. Relapses are observed in isolated cases.

The viral disease affects not only the skin, but also the nervous tissue. In view of this, the list of symptoms is expanded by the following manifestations:

• painful sensations of a paroxysmal nature, mainly at night;
• impaired skin sensitivity in the affected areas;
• muscle paresis, etc.

Treatment options for herpes zoster

If you notice any of the above list of symptoms of herpes zoster, try to see a doctor as soon as possible. If you do this within the first three days, all therapy may be limited to the use of antiviral drugs.

To reduce the intensity of pain and eliminate inflammation, the doctor may prescribe NSAID medications.

To reduce the severity of itching, various antihistamines are most often used. If there are symptoms of severe intoxication, detoxification therapy is used with further prescription of diuretics.

Only a doctor can prescribe any kind of medications and determine the order of their use. Do not self-medicate, as you risk making the situation worse.

Patients with manifestations of neuralgic lesions are usually prescribed sleeping pills and sedatives, as well as antidepressants. In the active stage of the disease the following are prescribed:

• painkillers and corticosteroids;
• tricyclic antidepressants;
• pain relief patches;
• anticonvulsants;
• opium-based analgesics.

The most commonly prescribed antiherpetic drugs are:

• Acyclovir;
• Famvir;
• Valtrex et al.

In addition to taking prescribed medications, the patient must follow certain rules for caring for rashes.

While taking a shower (and doing this if you have herpes zoster is not prohibited), do not rub the rash. If possible, avoid taking baths with aromatic oils and salts.

To reduce the severity of pain, you can apply cold to the affected areas, for example, a heating pad with ice. To relieve itching, it is recommended to make lotions with menthol or calamine.

If possible, keep the affected skin areas as unclothed as possible. It is better that contact with clothing is minimized, and contact with air, on the contrary, is maximized.

Do not treat the affected areas with any irritating ointments or creams - this will only make the situation worse.

There is no need to lubricate the rash with brilliant green, iodine and other similar substances - you will recover longer. There will be no effect from topical use of antiviral ointments.

Remember 3 main rules:

• do not panic;
• do not self-medicate;
• consult a doctor promptly.

Starting the fight against the virus in a timely manner allows you to quickly achieve positive results and prevent the development of complications. It is important that the treatment is carried out under the supervision of an experienced specialist. Otherwise, there is a high probability of developing complications.

Possible complications

The most common complication of herpes zoster is postherpetic neuralgia. Painful sensations along the affected nerves in some cases persist for many years. The likelihood of developing complications increases with age. If in patients under 50 years of age the risk of neuralgia does not exceed 1-2%, then in those over 70 years of age it increases to 25-30%.

In case of damage to the facial nerve, a complication may occur, expressed as rashes on the eyelids, and sometimes even in the cornea. This leads to the appearance of keratitis and other diseases that can cause glaucoma or blindness.

If the facial nerve is damaged, a complication may occur that will lead to the appearance of keratitis and other diseases that can cause glaucoma or blindness.

In isolated cases, the disease is accompanied by deep skin lesions, which leave scars.

The most dangerous complications of herpes zoster are:

• paralysis;
• muscle paresis;
• meningoencephalitis.

Other complications include severe headaches, poor tolerance to bright light, nausea, loss of consciousness, vomiting, and hallucinations.

Options for preventing herpes zoster

Viruses “love” people with weakened immune systems. To avoid this kind of disease, you must first of all work on strengthening the body’s protective functions. In general, prevention comes down to:

• healthy lifestyle;
• giving up any kind of bad habits;
• nutritious, regular and balanced nutrition;
• hardening;
• limiting exposure to the open sun.

Herpes zoster is a viral disease in which extensive rashes form on the skin on one side of the body.

Common herpes virus.

The causative agent of herpes zoster is the Zoster virus and most people encounter it in childhood, when they have chickenpox. After the disease subsides, the virus goes into a dormant form and awakens again only under certain conditions.

The virus that causes chickenpox in childhood does not leave the body after treatment. It stays with a person throughout life and can return with a more severe disease, which is shingles.

The virus can be activated as a result of exposure to certain external or internal factors that sharply weaken a person’s immunity.

Such factors may be:

• chemotherapy used to treat cancer, autoimmune diseases, and diseases of the circulatory system;
• long courses of immunosuppressants or steroid hormones;
• frequent stress;
• severe infectious diseases that weaken the immune system;
• acquired or congenital immunodeficiency;
• malignant tumors;
• hypothermia of the body;
• exposure to ultraviolet rays, which occurs with frequent sunbathing or visiting a solarium;
• elderly age.

Other reasons for decreased immunity are: heavy physical or mental stress, skin injuries, overwork. In women, herpes zoster, the symptoms and treatment of which are well studied, can occur during pregnancy.

Symptoms of herpes zoster

The incubation period can last many years. When the virus is reactivated, the patient begins to experience symptoms similar to chickenpox:

• malaise;
• increased skin sensitivity in some places;
• temperature increase;
• headache;
• enlarged lymph nodes;
• chills.

After 2 or 3 days, painful sensations will begin to appear, and along with them, rashes on the skin in the form of small reddish spots. These spots gradually transform into blisters, which contain a cloudy-transparent liquid inside.

The number of blisters will increase over 4-6 days, over time they begin to cover large areas of the skin. The rash can occur in waves, covering an increasingly larger area of ​​the body.

After some time, these blisters burst, leaving behind small ulcers, which are subsequently covered with dense crusts. It can take quite a long time for the ulcers to heal completely—sometimes up to 30 days. When the crust comes off, light spots will remain in its place, which will disappear in a couple of months. In rare cases, traces of herpes zoster may remain for the rest of your life.

It may have various symptoms, depending on which it is divided into several types, for each of which its own treatment is prescribed. Depending on the location of the rash and the characteristics of its course, the following forms of herpes zoster are distinguished:

1. Herpes on the head. In this form, the facial and trigeminal nerves are affected, which often leads to neuralgic disorders, numbness and paralysis of these nerves for a long period - up to several months. This type is always accompanied by high fever, pain in the eyes or ears, dizziness, the formation of ulcers in the mouth, constant nausea, and sometimes blurred vision in one eye. In rare cases, herpes on the scalp can cause severe brain damage.
2. Ganglycutaneous. It is characterized by extensive rashes on the body () along the nerve trunk affected by the virus. Causes intense pain, as well as intoxication of the body. The condition improves only after the ulcers heal.
3. Disseminated. It affects several internal organs or systems at once, with pronounced signs of intoxication, sometimes the pressure rises sharply.
4. Gangrenous. One of the most severe and dangerous forms, in which the skin rash turns into thick scars over time.
5. Abortive. It is characterized by a one-time skin rash and heals fairly quickly.
6. Meningoencephalitic. An extremely dangerous condition that affects the human nervous system.

The doctor may prescribe narcotic analgesics. If nerve branches are affected by herpes, symptoms such as constipation or diarrhea, impaired fine motor skills, urinary incontinence, paralysis or numbness of some parts of the body may appear.

Consequences and complications

Diagnostics

When it just begins to develop and the rash has not yet appeared, it is quite difficult to diagnose it. In the first stages, herpes is very similar to many other diseases - pancreatitis, angina pectoris, cholecystitis, appendicitis and others.

It becomes possible to diagnose herpes zoster when a rash appears on the skin, accompanied by fever and pain. In this case, the following examinations may be prescribed to clarify the diagnosis:

• general examination, study of the patient’s medical history and complaints;
• blood analysis;
• examination of a tissue sample to determine the type of virus.

In most cases, one examination of the patient is sufficient. Other tests are prescribed very rarely, only when there is a suspicion of other diseases.

Treatment

Herpes zoster is treated on an outpatient basis. The patient is hospitalized only if there is a threat of brain damage, or in very severe cases when it affects internal organs.

The main goal of therapy is to reduce pain, prevent secondary infection and other complications. The following medications are usually prescribed:

• Antiviral drugs – Famciclovir, Viferon, Acyclovir. They reduce pain, help to cope with the disease faster, and also prevent the development of complications, primarily neuralgia. These medications are taken for about 10 days.
• Painkillers. For mild pain, non-narcotic analgesics are prescribed - Ketorolac, Naproxen, Ibuprofen, Paracetamol, Ketoprofen. Thanks to them, it becomes easier for the patient to breathe and move. In severe cases, with severe paroxysmal pain, anticonvulsants (for example, Carbamazepine) or ganglion blockers (Quarteron, Timekhin and others) are prescribed. If postherpetic neuralgia occurs, drugs such as Oxycodone, Pregabalin, Gabapentin can be used.
• Immunomodulators – Geneferon, Cycloferon. These products strengthen the immune system and help fight the virus.

If medications alone fail to reduce pain, additional measures may be prescribed:

• Blockades. Painkillers are injected into the soft tissues that surround the diseased nerves. Such procedures help relieve severe pain for a while.
• Electrical nerve stimulation. A procedure that normalizes the functionality of nerve endings affected by the disease and eliminates pain.

In the initial stage of herpes zoster, when the skin rashes have not yet gone away, you should not take water treatments. Only as a last resort is it permissible to rinse in the shower and then gently pat the skin dry with a towel. Under no circumstances should you rub it.

Prevention

To prevent the disease, you should strengthen the immune system and reduce the influence of factors that can trigger the development:

• lead a healthy lifestyle;
• promptly treat infectious and inflammatory diseases;
• walk in the fresh air more often;
• avoid emotional, physical or mental stress;
• maintain a balanced diet;
• take vitamin complexes.

Which doctors should you contact?

Herpes zoster often manifests itself with symptoms that are very similar to many other dangerous diseases, so delaying contact with a doctor is strictly not recommended. Several doctors provide treatment: a dermatologist, a therapist, an ophthalmologist, a neurologist, and an infectious disease specialist.

Herpes zoster is a very serious disease that can cause many complications, including the death of the patient. When the first signs appear, you should immediately consult a doctor. The sooner treatment begins, the greater the chance of a successful outcome.

Who said that curing herpes is difficult?

• Do you suffer from itching and burning in the areas of the rash?
• The sight of blisters does not at all add to your self-confidence...
• And it’s somehow embarrassing, especially if you suffer from genital herpes...
• And for some reason, ointments and medications recommended by doctors are not effective in your case...
• In addition, constant relapses have already become a part of your life...
• And now you are ready to take advantage of any opportunity that will help you get rid of herpes!

There is an effective remedy for herpes. and find out how Elena Makarenko cured herself of genital herpes in 3 days!