Shingles: What You Should Know | Johns Hopkins Medicine
What is the danger of shingles?
The diagnosis of lichen causes panic in many. What if you or your family are diagnosed with this? Should you panic? And how to effectively and quickly get rid of an unpleasant disease?
Mechanism of shingles
The introduction or increased activity of the herpes virus of the Varicella zoster species causes the appearance of the disease. The clinical picture is specific unilateral rash, the skin under which hurts even in a calm state, without touching.
Primary contact with this virus in childhood causes chickenpox, and in older people who have already had chickenpox, symptoms of shingles are expressed.
Treatment of the disease does not consist in smearing the papules with an antiseptic - it is more serious, since there is a possibility of complications.
When the branches of the nerves are damaged - paralysis of various nature, when involved in the inflammatory process of internal organs - the spread of the virus through the lymph and bloodstream - the consequences of herpes zoster can be pneumonia, hepatitis of various etiologies, diseases of the digestive organs.
With a purulent-inflammatory process, secondary infection may appear, and there is a risk of bacterial or fungal infection. After chickenpox, immunity is developed. In this case, the virus does not disappear, but in a latent form remains in the posterior parts of the spinal cord and branches of the cranial nerves - in nerve cells.
As soon as a favorable condition is created - a decrease in the immune status, regardless of the reasons influencing it - the virus wakes up. It travels along the nerve branches and reaches the area of the skin surface for which is responsible this nerve. This area of the skin begins to ache, itch, then characteristic herpetic eruptions appear on it - papules with serous contents.
If the integrity of the papules is violated - it is very difficult to resist scratching, experiencing severe itching - weeping inflamed areas are formed. After recovery, pain and itching may persist for years. This phenomenon has a name - postherpetic neuralgia.
Symptoms and manifestations of shingles
The reasons for this type of lichen can be different. Waking up illness is possible not only when there isthe development of internal factors - exacerbation of chronic pathological conditions or the introduction of infection, but also in the treatment of oncology, taking certain medications. The virus can be activated by hypothermia, allergic reactions, intoxication.
Clinical forms of herpes zoster.
- Gangliocutaneous. Initially, there is a general fever and painful sensations, accompanied by itching and tingling at the site of future rashes. Then pink spots with vague edges appear, and bubbles with serous contents form on them. Such rashes are usually located on the chest or lower back on one side, the pain increases with cooling, touching, movement. Rash is optional;
- Ear and eye shape. In most cases, the site of the trigeminal nerve is affected - the place from which the nerve roots exit. The inflammatory process covers the eyeball and the geniculate node. Rashes are localized on the eyelids, on the auricle and around it, in the ear canal. With such symptoms, specific viral keratitis, glaucoma and iritis can be diagnosed;
- Gangrenous form. The appearance of areas with necrosis is typical for persons with a history of lowered immune status. The deep layers of the epidermis are affected, necrotic scars are formed. In this case, the most common secondary infection is fungal or bacterial;
- The occurrence of shingles with damage to the autonomic ganglia has the following symptoms: intestinal upset, urinary retention, decreased bile secretion. Signs are quite rare, and before the appearance of rashes, it is difficult to diagnose the herpes nature of the onset of pathological disorders;
Meningoencephalitic form. This is a very serious condition - the death rate among
cases reaches 65%. First, the ganglionic sections are affected - more often in the neck or ribs of the chest. Then the typical symptoms of meningoencephalitis begin: vomiting, disturbances of consciousness, hallucinations. If the patient manages to fall into a coma before medical care is provided, it is problematic to get him out of this state;
- Disseminated form - in this case, the rash can be localized simultaneously in several parts of the body - on the lower back, chest, in the facial region.
Usually, the manifestations of herpes zoster disappear in 2-4 weeks. Ifthe rash does not disappear longer, and the rash continues to appear, the affected area increases, the appearance of the skin begins to resemble chickenpox disease, then it is necessary to be tested for HIV.
Clinical picture of the disease
Shingles can be treated at home as long as the symptoms are the same as usual. In case of aggravation of the condition, hospitalization is necessary.
The initial stage lasts up to 4 days.
At this time, the following symptoms occur:
- the temperature rises to almost 40 ° C;
- skin pain and itching;
- regional lymph nodes enlarge.
Urinary disorders, urinary retention, angina pectoris, tachycordia, nausea and vomiting may also become active.
As soon as the rash appears, the symptoms of intoxication disappear. Bubbles with liquid contents are small at first, then the liquid becomes cloudy. With a necrotic form in the vesicles, hemorrhagic contents. Fresh rashes can appear, as with chickenpox, within a few days.
One area is freed - the rashes move to another, one might even say - crawl .
If the rash does not occur (for example, in a mild form), the pain is taken for cardiac or rheumatic.
After 7-10 days, crusts appear on the site of the vesicles. Papules dry up, turn pale, crusts fall off. Pigmentation fades over time.
Treatment for herpes zoster
If the disease appears in people with a temporary deterioration in the immune status - the occurrence is caused by external causes - treatment for herpes zoster is not required. In this case, it is enough to use folk remedies at home.
To enhance immunity, you can drink ginger tea, tincture of ginseng, willow bark and lemongrass. You can use tinctures of calendula, chamomile, oak bark and lotion string to quickly relieve inflammation. But since moisture provokes the growth of inflammation, you can limit yourself to cauterizing the vesicles with brilliant green or fucorcin.
Treatment of herpes zoster with folk remedies in people with a reduced immune status or with a severe course is not enough. In this case, it is necessary to adhere to medical prescriptions. To eliminate pain, non-specific steroid drugs or analgesics are used. To relieve discomfort and pain caused by rashes - gels or ointments with lidocaine.
Antiviral drugs are prescribed: Valacyclovir , Famciclovir Tera , Acyclovir , not only orally, but also by injection. Antiviral, analgesic and anti-inflammatory agents are applied to the skin, for example, Epigen cream.
When attachingResolving secondary infection may require therapy with antibacterial or antifungal agents.
In no case should you apply corticosteroid products to the skin - they further weaken the immune status. During illness, it is strictly forbidden to carry out hygiene measures through water procedures - general ablutions.
Is shingles contagious?
Infectionists cannot yet answer this question unambiguously. It is believed that for people who have not had chickenpox, contact with sick people is dangerous.
The virus can be introduced by airborne droplets, transmitted by contact and through objects that the patient used. The mother can transmit the virus through the bloodstream to the fetus.
As soon as the crusts dry up, the patient becomes non-infectious to those around him.
For those who have had chickenpox, contact with the sick is threatened in exceptional cases - only when they contracted the underlying disease that caused a decrease in immunity.
If signs of illness appear, consult a doctor - inadequate treatment aggravates the course of herpes zoster, which can lead to complications.