Herpes zoster is also called herpes zoster - a viral infection that is accompanied by severe pain and skin rashes.
The disease is provoked by the herpes virus (herpes zoster), it acts as the causative agent of chickenpox, which in medical circles is called chickenpox.
Manifestations of shingles occur, as a rule, in winter and autumn, and more often in elderly people. Such a time and age are due to a simple fact - the state of immunity, which is reduced in these seasons, and in older people due to age - is weakened.
What it is? So, herpes zoster is essentially herpes. Only here is not the one that we usually call a cold. It's all much more serious. This is a Varicella zoster. He is familiar to many from active childhood disease - chickenpox.
A person who has had chickenpox becomes a carrier of a virus that has been in an inactive form for a long time. Usually the virus is localized in the nerve tissues. According to doctors, the virus enters the active form, most often due to weakening of the immune system, frequent stresses and nervous overvoltages.
To provoke the development of shingles in adults can:
- strong stress, exhausting work;
- taking drugs that reduce the body's defenses;
- various malignant tumors, Hodgkin's disease and non-Hodgkin's lymphomas;
- the effects of radiation therapy;
- bone marrow and organ transplants;
- HIV infection in transition to AIDS.
Weakened immunity is the reason why this disease most often appears in adult elderly people and in those who have recently undergone hormonal, radiation or chemotherapy.
In most cases, herpes zoster occurs in typical form, which is classified as ganglion, its symptoms will be described below. But in some cases, the disease may manifest itself in other clinical forms:
- Ear. The rash is localized on the auricle, in the external auditory canal.
- Ocular. The rash is chosen localization of the branch of the trigeminal nerve and appear on the skin of the face, nasal mucosa, eye mucosa.
- Gangrenous (necrotic). It develops in people with weakened immunity.
- Meningoencephalitic. It is quite rare and differs in its severe course.
- Abortive. It is considered the most mild form of the disease, characterized by the absence of a bubble rash and a strong pain syndrome.
- Cystic. This form is accompanied by the appearance of large bubbles filled with serous fluid.
- Hemorrhagic. This form is characterized by the appearance of bubbles filled with bloody contents.
Symptoms of Shingles in Adults
The total period of shingles in a person from the appearance of the first symptoms to the complete disappearance of scabs on the skin is usually 20-30 days. Sometimes the disease can end completely in 10-12 days.
It is very characteristic of shingles that the rash when it appears on any one side of the body. In most cases, all external manifestations of shingles are on the body - within the chest, abdomen and pelvis. In more rare cases, they can be localized on the arms, legs and head.
The initial period of the disease is similar to manifestations of a cold or ARVI. It is characterized by general malaise, neuralgic pains of varying intensity, it lasts an average of 2-4 days:
- Subfebrile body temperature, less often fever up to 39C.
- Chills, weakness.
- Diarrheal disorders, violation of the gastrointestinal tract.
- Pain, itching, burning, tingling in the region of the peripheral nerves in the area where there will be rash.
- Most often, during an acute process, regional lymph nodes become painful and become enlarged.
- In case of severe disease, urinary retention and other disorders of some systems and organs are possible.
The next stage is characterized by the appearance of edematous pink spots, they are grouped within 3-4 days into erythematous papules, which quickly turn into bubbles. At about 6-8 days the bubbles begin to dry out, or yellow-brown crusts appear on their place, which then disappear on their own, in their place a slight pigmentation may persist.
Painful sensations, also called postherpetic neuralgia, can torment a person for several weeks, or even months, after the remaining symptoms of depriving him disappear.
The above clinic is typical for the typical form of the disease, but sometimes the rash may have a different character:
- Abortive form - after papule formation, the rash regresses sharply, bypassing the vesicular stage.
- The bubble form is characterized by the development of larger bubbles grouped together; exudative elements can merge, forming bubbles - with uneven scalloped edges.
- Bullous form - vesicles merge with each other, forming large blisters with hemorrhagic contents.
- Gangrenous form of shingles is the most severe manifestation of the disease; ulceration-necrotic changes develop in place of the vesicles - with an outcome in scarring; at the same time there is a serious general condition (reflects pronounced immunosuppression).
- Generalized form - after the appearance of local eruptions, new vesicles spread over the entire surface of the skin and mucous membranes (this form is often found in immunodeficiencies).
It is worth noting that before the appearance of the rash, the diagnosis of shingles is practically impossible to make. The arising pains (depending on localization) may resemble diseases of the heart, lungs, nervous system. After the development of the characteristic rash - with one-sided localization of exudative elements along the nerves (monomorphic elements - bubbles of various sizes), as well as pronounced neurological pain - the diagnosis of shingles is not difficult.
How does shingles look like in an adult, we offer for viewing detailed photos of skin rashes.
In severe clinical course and inadequate treatment of shingles can lead to serious complications:
- The most common (up to 70%) is postherpetic neuralgia. Pain along the nerve remains for months, and some last for years, and the older the patient, the greater the chance that this complication will develop;
- Paralysis, resulting from the defeat of the motor branches of the nerves;
- Paralysis of the facial nerve and skewed face to one side;
- Inflammation of the lungs, duodenum, bladder;
- Eye damage of varying severity;
- Meningoencephalitis is an extremely rare, but the most dangerous complication. In the period from 2 to 20 days from the onset of the disease there is a severe headache, photophobia, vomiting, there may be hallucinations and loss of consciousness.
In connection with the risk of consequences, experts urge patients to give up self-treatment at home and promptly seek help from specialized institutions.
Treatment of shingles in humans
Uncomplicated cases are treated at home. Hospitalization is indicated to all people with suspected disseminated process, with damage to the eyes and brain.
In most cases, herpes zoster in an adult can go away on its own if untreated. However, without the use of medications, there is a high probability of developing serious complications of the disease, as well as the impossibility of enduring severe pain in the acute and chronic phase. Methods of treatment are aimed at accelerating recovery, reducing pain and preventing the effects of herpes.
The treatment regimen for shingles in a person is based on the use of the following drugs:
- Antiviral agents. Acyclovir, valacyclovir and famciclovir are used to treat shingles. When starting therapy within 72 hours of the appearance of the first rash, they are able to reduce the severity of pain, reduce the duration of the disease and the likelihood of postherpetic neuralgia. Famciclovir and valaciclovir have a more convenient regimen than acyclovir, but they are less studied and several times more expensive.
- Painkillers. Anesthesia is one of the key points in the treatment of shingles. Adequate anesthesia makes it possible to breathe normally, move and reduce psychological discomfort. Of the common analgesics used: Ibuprofen, Ketoprofen, Dexketoprofen, etc.
- Anticonvulsants. Anticonvulsants are commonly used for epilepsy, but they also have the ability to reduce neuropathic pain. When Herpes zoster can be used some of them, such as gabapentin and pregabalin.
- Antidepressants. The positive role of antidepressants in the treatment of postherpetic neuralgia has been shown.
- Corticosteroids. Reduce inflammation and itching. Some studies have shown their ability in combination with antiviral agents to reduce the symptoms of mild and moderately severe forms of the disease. However, currently these drugs are not recommended for use in this disease.
Appointment of drug therapy is necessary primarily for those people who have a high risk of complications, as well as with a protracted course of the disease. Drug therapy is indicated for persons with immunodeficiency and for patients whose age has exceeded the 50-year barrier. The effectiveness of antiviral therapy in young and healthy people has not been proven.
With shingles, it is important not to panic. In most cases, timely initiated antiviral treatment gives quick results and helps to avoid complications. However, to neglect a visit to a specialist, especially if the facial or trigeminal nerve is involved, is also not worth it.
Which doctor to contact
If bubbles appear on the skin or mucous membranes, you need to contact a dermatologist. In some cases, additional examination is required by a neurologist. With a long, severe, recurrent course, consultation of an immunologist and an infectious disease specialist is necessary.