Herpes zoster: symptoms and treatment in adults, photos, prognosis. It is important to know whether shingles is contagious or not? Causes and treatment Shingles recurrent disease

Shingles - viral disease accompanied by inflammation of the nerve nodes. This disease in humans can affect not only individual areas of the skin, but also internal organs.

Disease code according to ICD 10 ( International classification diseases 10th revision):

B02 – herpes zoster;
B02.0 – herpes zoster with encephalitis;
B02.1 – herpes zoster with meningitis;
B02.2 – herpes zoster with other complications nervous system;
B02.3 – herpes zoster with ocular complications;
B02.7 – disseminated herpes zoster;
B02.8 – herpes zoster with other complications;
B02.9 – herpes zoster without complications.

The causative agent of herpes zoster and chickenpox is the same virus, so their etiology and clinical picture are very similar. However, if you have chickenpox, you can become infected with this virus by airborne droplets, and with herpes zoster, infection is possible through contact with a damaged area of the patient’s skin. There are basic clinical guidelines for disease prevention:

When treating affected areas of the skin, you need to wear rubber or medical gloves;
Do not use the patient’s clothing, towels or other hygiene products;
Strengthen the nervous system (from a psychosomatic point of view, the appearance of a disease is a consequence of constant experiences, nervous breakdowns).

Classification of forms of herpes zoster:

Gangliocutaneous - protrudes on the skin at the site of damage to the nerve nodes;
Necrotic – occurs when the immune system is weakened and is accompanied by the formation of ulcers;
Ophthalmic – the location is the trigeminal nerve;
Ear – localization of the zoster virus in the ears;
Hemorrhagic - the formation of blisters containing blood;
Cystic - the formation of large blisters with serous fluid;
Abortive form - accompanied by the absence of pain and blisters.

According to people's reviews, the disease is accompanied by severe pain in the affected area.

Symptoms of herpes zoster

The first signs of the disease can easily be confused with a regular acute respiratory viral infection or acute respiratory infections last approximately 3-5 days:

Dizziness;
Weakness in the body;
Increased body temperature, accompanied by chills or fever;
Apathy;
Disruption of the gastrointestinal tract.

Important! If you detect at least one of the following signs, you should immediately contact a specialist:

Loss of consciousness;
Photophobia;
Prolonged headaches;
Hallucinations;
Vomit.

What they look like external signs Shingles? In the area of skin under which the nerve nodes are inflamed, pink spots, in place of which papules will appear within four days. After another two to three days, bubbles with serous fluid form in their place. On the eighth day of illness, they will dry out, and in their place a yellow-brown crust will form, which will then fall off on its own. After recovery, light pigment spots form at the site of the affected area of the skin, which in most cases disappear.

The causes of shingles are:

Stressful situations;
Weakened immunity;
Taking medications to weaken the body’s defenses (mostly such drugs are taken by people who have undergone organ transplant surgery);
Oncological diseases;
Contact with an infected person.

In order to understand what causes the zoster virus in the body, it is enough to know whether a person has had chickenpox. This virus, entering the human body, first causes chickenpox, and then remains in the body for life in a state of “sleep”. As soon as the immune system weakens, it manifests itself in the form of herpes zoster. In winter and autumn there are exacerbations, since at this time of year the body is more weakened.

In order to understand which doctor to contact when the first symptoms are detected, it is worth visiting a therapist. During the examination, he will be convinced of the nature of the disease and will write a referral to a dermatologist or infectious disease specialist, who, in turn, will prescribe a series of studies to diagnose the disease:

PCR diagnostics;
General blood analysis;
Blood test for the presence of antibodies to the zoster virus.

Where does shingles occur and what parts of the body does it affect?

The most common areas affected by herpes zoster are:

Back;
Hips and buttocks;
Stomach;
Skin along the intercostal areas.

It is rare to see lesions on areas of the skin:

On the face, head, neck;
On the arms and legs;
In the mouth;
On the genitals (mainly in HIV patients).

Incubation period of herpes zoster

How long does it last incubation period herpes zoster? The duration of the incubation period varies from several days to several years. At strong immunity the disease does not develop, since the activity of the virus is suppressed by the body. As soon as the body’s defenses weaken, characteristic symptoms and pain appear.

How long does the disease last? Light form Herpes zoster goes away on its own within two weeks. It is worth noting that in older people, any form of the disease will be more severe than in young people, since the immune system at this age is weakened and vitamins are poorly absorbed. In this case, you must consult a doctor to prescribe treatment with antiviral drugs.

Shingles can occur without rashes, but this does not mean that the disease progresses favorably. Due to the absence of papules and vesicles, doctors may make an incorrect diagnosis, and because of this, the disease may develop complications.

Prevention of herpes zoster

To prevent the disease, you should follow some recommendations:

Prevent contact with the infected;
Do not use the patient's clothes and towels;
Bed linen and clothes of the infected person should be washed separately, and after drying, ironed at the highest possible temperature;
Take immunomodulators. These medications are necessary to improve immunity.
Get vaccinated against shingles.

Vaccination against herpes zoster is necessary for adults and older people who have not had chickenpox. The vaccine strengthens the immune system, suppresses the activity of the virus and reduces the risk of relapse and complications.

Bathing is one of the main means of maintaining hygiene. However, scientists have not been able to definitively answer whether it is possible to wash with shingles. Some say that you should not swim if you have this disease, others say that to treat the disease you should take water treatments With sea salt, and still others say that you can take a shower, after which you need to carefully blot the remaining water with a towel.

The consequences of herpes zoster

Delayed treatment for herpes zoster can result in the following complications:

The presence of scars and age spots on the skin;
Paralysis facial nerve and facial distortion;
Loss of vision and hearing;
Loss of sensation;
Problems urinating;
Postherpetic neuralgia.

After recovery, pain remains in the areas of inflammation of the nerve nodes. It may be accompanied by itching and numbness. The question: “How to relieve pain after shingles?” can only be answered by a neurologist. For the treatment of postherpetic neuralgia the following are used:

Painkillers;
Local ointments and solutions;
Antidepressants;
Non-steroidal anti-inflammatory drugs.

If the disease occurred in mild form, then there will be no complications or relapses. Before you say whether the disease can recur or not, it is worth remembering that the zoster virus is not eliminated from the body in any way, it is simply in a latent state. You can get sick again during periods of exacerbation (winter and autumn), since the immune system is weakened.

Shingles during pregnancy

Infection with zoster virus early stages pregnancy, leads to infection of the fetus. Shingles during pregnancy leads to:

Polyhydramnios;
Premature birth;
Delayed fetal development.

When found bloody discharge from the genitals, you should immediately consult a doctor.

Treatment of herpes zoster in pregnant women is carried out under the guidance of a gynecologist and an infectious disease specialist. Drugs are prescribed with caution to avoid negative influence for the fruit. In the second trimester, the expectant mother can undergo treatment with Acyclovir, but this drug is not recommended for use in the first trimester. Painkillers are prescribed only when absolutely necessary, as they can cause miscarriage or premature birth. After birth, the mother is placed in a separate box, and the baby is given special care for two weeks

Herpes zoster in HIV

The virus that causes HIV infection and the zoster virus provoke mutual hyperactivation. This happens due to the fact that the body’s defenses are weakened by immunodeficiency.

Symptoms of herpes zoster in HIV infection:

Rash on the face and genitals;
Dysfunction internal organs;
The appearance of ulcers on the skin, genitals, and urethra;
The appearance of rashes in the mouth and ears.

During the treatment of herpes zoster with immunodeficiency, use a double dose antiviral drugs. However, the problem is that HIV-infected people need to use special medications because they have lost sensitivity to standard drugs.

Herpes zoster in old age

Herpes zoster most often occurs in older people. The reason for this is weakened body defenses and poor absorption of vitamins. In older people, the disease is more difficult, since many drugs are prohibited from being used at this age. The patient urgently needs to be hospitalized if:

His age is over 70 years;
There is the presence of acute chronic diseases;
Eat allergic reaction for medicines.

The patient must strictly adhere to the therapy prescribed by the specialist in order to avoid consequences. Possible complications herpes zoster in old age:

Loss of sensation;
Blindness and deafness;
Paralysis;
Inflammation of the brain;
Disruption of the gastrointestinal tract;
Development of pneumonia;
Defeat spinal cord.

During treatment, antiviral, antihistamine, and painkillers are prescribed. However drug treatment it is recommended to alternate with traditional medicine. The most common treatment options for herpes zoster are:

Wipe the affected areas of the skin with baking soda dissolved in water.
Rub the affected areas with chopped garlic;
Dilute two tablespoons of propolis in 125 ml of alcohol and leave for a week. The solution must be stirred every day. Then you need to add one teaspoon of solution to a glass of boiling water and drink it before eating. This remedy should be used for four days, twice a day;
To get rid of itching, it is recommended to wipe the affected areas with apple cider vinegar;
Compress made from crushed cinquefoil;
Infusion of meadowsweet and calendula. Add two tablespoons of plant flowers to 0.5 liters of vodka and put them in a dark place. The resulting infusion can be used internally or local application. One teaspoon of infusion is added to a glass warm water and is drunk during meals. To treat the affected area of the skin, it is recommended to make compresses with this infusion for 15 minutes.

To treat shingles in old age and prevent relapse, it is recommended to lead an active lifestyle, take walks every evening, take vitamins, watch your diet, and avoid walking in the sun, as it affects the development of the virus.

Do you still have questions related to the course of herpes zoster and its treatment? Watch these tips from a doctor in the video:

The herpes virus is becoming familiar to more and more people. Most often, people without medical education associate herpes infection with rashes on the lips.

However, it is worth knowing that one type of virus, namely herpes zoster, can also cause shingles in adults.

At the same time, unlike chickenpox, herpes zoster (shingles) is a rather painful disease. And if chickenpox in children goes away without any treatment with the formation of stable immunity, then herpes zoster can recur many times and requires immediate treatment.

Knowing the first symptoms of herpes zoster effective scheme treatment of human disease and preventive measures will protect against complications and speed up recovery.

photo of rash

The herpes zoster virus first enters the body during chickenpox. Elimination of chickenpox rashes does not mean the death of the infectious agent. The virus is kept in a weakened state by the immune system and remains in the body constantly after chickenpox.

Shingles is external manifestation activated against the background of decreased immunity of the herpes virus. The disease is registered only in people who have had chickenpox!

Activations Herpes zoster is promoted by:

hypothermia,
previous acute respiratory infection or influenza (any other disease leading to a sharp weakening of the immune system),
stress,
visiting a solarium or prolonged exposure to the sun,
oncology and radiation therapy,
severe infections - HIV,
long-term use of corticosteroids and treatment with immunosuppressants,
pregnancy (often the disease occurs without skin rashes and severe pain, but has a negative effect on the development of the fetus).

Is herpes zoster contagious or not?

Shingles is an infection. Therefore, the answer to the question about the contagiousness of the disease is clear: yes, it is contagious. However, the incidence of herpes infection occurs according to the following rules:

A person (most often a child) who has not previously had chickenpox, when in contact with someone with shingles, becomes ill with chickenpox after about 21 days.
Symptoms of shingles in adults - a characteristic rash on the torso (see photo), severe pain along the nerves, a flu-like condition - occur only in people who have had chickenpox against a background of weak immunity.
The risk of contracting a herpes infection directly depends on the strength of the immune system: the weaker the immune system, the higher the likelihood of disease.

Most often, herpes zoster is diagnosed in older adults with a noticeable physiological decline in all body functions, including immune defense. However, the appearance of herpetic rashes on the body of a teenager cannot be ruled out.

Infection with shingles occurs by airborne droplets and contact (the liquid of the bubbles contains a large number of virus) by.

How dangerous is shingles?

Skin rashes- not the worst manifestation of the disease. Herpes zoster is dangerous because it damages peripheral nerves.

Being in nerve endings, the virus in an active state destroys their structure, thereby causing unbearable pain in shingles and many neurological complications.

Symptoms of herpes zoster by stages, photos

herpes zoster in adults, photo of the nature of the rash

manifestations on the head and face

Watery blisters on the body, complaints about severe pain and decreased performance - this is how shingles manifests itself in the opinion of many people.

However, this picture is observed only at the height of the disease; the onset of a herpes infection is not accompanied by a skin rash, and therefore is often perceived as a common cold.

Stages of herpes zoster:

The initial stage of herpes zoster(flu-like)

Herpes zoster begins acutely. Suddenly there is a feeling of discomfort, joint and muscle pain, slight increase in temperature.

However, other symptoms also interfere with the flu-like picture: itching and burning appear on the skin where herpetic rashes will soon appear (along the nerves, for example, along the costal arches). Similar symptoms are observed within 1.5-4 days.

Skin rash stage

First, along the nerve damaged by the virus, pale pink spots with unclear boundaries and a diameter of 2-5 mm appear. Against their background, bubbles with clear liquid appear very quickly, and regional lymph nodes enlarge. Over the next week, the number of small vesicles increases significantly.

Shingles looks like a cluster of yellowish blisters on one side of the body, as if encircling it. However, herpetic eruptions often appear on the face (the part of the face innervated by the trigeminal nerve).

It is during this period that the most striking clinical picture is observed: heat up to 38-39ºС, unbearable burning pain, severe itching.

This condition can last up to 3 weeks, the duration of the disease depends on the degree of immunodeficiency. Increased pain when moving or when the skin comes into contact with clothing seriously affects both the general well-being (nervousness, insomnia) and the patient’s performance.

Stage of involution (crust formation)

Gradually, the liquid in the herpetic blisters becomes cloudy, they begin to dry out with the formation of yellow/brownish crusts. In their place normal course During the course of the disease, slight pigmentation remains for some time. However, the pain does not subside.

The typical course of herpes zoster is described above. Sometimes the disease gives an atypical clinical picture:

Abortive form - there is no stage of formation of watery vesicles. Despite the absence of a skin rash, the pain is just as intense.
Bullous form - vesicles increasing in size merge, forming blisters of large diameter.
Hemorrhagic form - deep tissue destruction with damage to the skin capillaries leads to the filling of the blisters with blood. Healing occurs with the formation of scars and dimples on the skin.
Gangrenous form - deep ulcers form in place of the vesicles. Healing is delayed, and eventually rough scars form in their place.

Treatment of herpes zoster in adults, drugs

Timely treatment herpes zoster in adults will help eliminate painful symptoms as quickly as possible and prevent the development of complications. The complex of drug therapy for lichen includes the following drugs:

Antiviral agents (Acyclovir, Valaciclovir, Penciclovir, Famciclovir) - in tablets and ointments. The drugs act on the cause of shingles - the herpes virus. However, they do not kill the infection, but only inactivate it. The greatest effectiveness of antiviral therapy is achieved when taking Acyclovir in the first 3 days of the disease. The course of treatment is 10 days.
To reduce the pain of herpes zoster, NSAIDs (Meloxicam, Nimesil, Naproxen) and lidocaine ointments are used. In cases of unbearable pain, novocaine blockade of the damaged nerve is often performed.
To normalize sleep and relieve nervous tension- sleeping pills, sedatives.
Antihistamines (Suprastin, Tavegil, etc.) - reduce itching.
Infusion therapy - intravenous infusion of Ringer's solution and 5% glucose with simultaneous administration diuretics perfectly eliminate the symptoms of intoxication.
Local effects - brilliant green and Fukarcin for treating the skin (has an antiseptic and mild drying effect), Solcoseryl ointment for speedy healing (used at the stage of regression or for difficult-to-heal ulcers).
Antibiotics (Gentamicin, Rifampicin, Tetracycline, Erythromycin, Oxacillin) - appropriate only in cases of accession bacterial infection and the development of pyoderma. They are used in the form of ointments and tablets, in severe cases- i.v. Ribavirin, IM Cycloferon.
Vitimanotherapy - B vitamins will prevent the destruction of nervous tissue and, in combination with other medications, help reduce pain.
Vaccination - administration of a weakened herpes zoster virus in combination with antiviral therapy is excellent preventive measure preventing the development of relapses.

It is advisable to treat herpes zoster with hospitalization only in severe cases of the disease and the threat of complications. The treatment regimen and duration of drug intake are determined by a qualified dermatologist.

Self-prescription of medications - for example, corticosteroids even in the form of ointment (Prednisolone, Hyoxysone, Triderm) - will only worsen the patient’s condition and, moreover, self-medication with home remedies can contribute to the spread of infection and the development of severe consequences.

Is it possible to swim if you have shingles?

a strict contraindication to taking a bath or shower. Areas with rashes and nearby skin should never be wet to prevent the spread of infection.

Partial washing of hands/feet, wiping the neck and face with a damp cloth is acceptable, provided there are no rashes on them. In this case, the patient must be given a personal towel and change his underwear regularly.

How long does the pain from shingles last?

Even after effective treatment In 70% of patients, intense pain persists for some time (several months and even years, on average 3-6 months).

Postherpetic neuralgia is caused by the destruction of nervous tissue, and it is the nervous tissue that is characterized by a long recovery. Therefore, it is so necessary to begin comprehensive treatment from the first days of the disease.

Complications

Unlike chickenpox, complications of which are extremely rare, shingles is fraught with serious consequences. In addition to scars on the skin and long-term pain (post-herpetic consequences), the disease can provoke:

pyoderma (suppuration of herpetic blisters);
eye damage, often leading to blindness;
meningoencephalitis;
disturbance of sensitivity and motor function(paresis, paralysis) of the limbs;
violation respiratory function(respiratory paralysis), threatening rapid death;
problems with bowel movements (constipation, diarrhea) and urination (urinary incontinence or retention);
hepatitis, viral pneumonia;
during pregnancy - miscarriage, stillbirth, birth of a baby with severe brain pathology, blindness, deafness.

Shingles is also called herpes zoster - it is viral infection, which is accompanied by severe pain and skin rashes.

The disease is provoked by the herpes virus (herpes zoster), which is the causative agent of chickenpox, which in medical circles is called “chickenpox”.

Manifestations of shingles usually occur in winter and autumn, and most often in older people. This time and age are due simple fact– the state of immunity, which is reduced at these times of the year, and in older people, due to age, weakened.

Causes

What it is? So, shingles is essentially herpes. Just not the one we all usually call a cold. Everything is much more serious here. We are talking about Varicella zoster. He is familiar to many due to his active childhood illness -.

A person who has had chickenpox becomes a carrier of the virus, which is for a long time in an inactive form. The virus is usually localized in nerve tissues. According to doctors, the virus becomes active form, most often due to weakened immunity, frequent stress and nervous strain.

Provoke development Shingles in adults can:

severe stress, exhausting work;
taking medications that reduce the body's defenses;
various malignant tumors, lymphogranulomatosis and non-Hodgkin's lymphomas;
influence of radiation therapy;
bone marrow and organ transplantation;
in the stage of transition to AIDS.

Weakened immunity is the reason why this disease most often occurs in older adults and in those who have recently undergone hormonal, radiation, or chemotherapy.

Classification

In most cases, shingles occurs in a typical form, which is classified as gangliocutaneous, its symptoms will be described below. But in some cases, the disease can manifest itself in other clinical forms:

Symptoms of herpes zoster in adults

The total period of shingles in humans 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 completely end in 10-12 days.

It is very characteristic of herpes zoster that the rash appears on one side of the body. In the vast majority of cases, all external manifestations of shingles are on the torso - 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 the manifestations of a cold or. It is characterized by general malaise, neuralgic pain of varying intensity, which lasts on average 2-4 days:

Headache.
Low-grade body temperature, less often fever up to 39C.
Chills, weakness.
Dyspeptic disorders, disruption of the gastrointestinal tract.
Pain, itching, burning, tingling in the area peripheral nerves in the area where there will be rashes later.
Most often when acute process Regional lymph nodes become painful and enlarged.
In severe cases of the disease, urinary retention and other disorders of certain systems and organs may occur.

The next stage is characterized by the appearance of edematous pink spots; within 3-4 days they group into erythematous papules, which quickly turn into vesicles. At about 6-8 days, the blisters begin to dry out, and yellow-brown crusts appear in their place, which then disappear on their own; in their place, slight pigmentation may remain.

Painful sensations, also called postherpetic neuralgia, can torment a person for several weeks or even months after the remaining symptoms of lichen have disappeared.

Atypical course

The above-described clinical picture is typical for the typical form of the disease, but sometimes the rash can be of a different nature:

Abortive form– after the formation of a papule, the rash sharply regresses, bypassing the vesicular stage.
The vesicular form is characterized by the development of larger bubbles, grouped; exudative elements can merge, forming blisters - with uneven scalloped edges.
Bullous form - vesicles merge with each other, forming large blisters with hemorrhagic contents.
Gangrenous form herpes zoster is the most severe manifestation of the disease; in place of the vesicles, ulcerative-necrotic changes develop - resulting in scarring; at the same time there is severe general state(reflects severe immunosuppression).
Generalized form– after the appearance of local rashes, new vesicles spread over the entire surface of the skin and mucous membranes (a similar form is often found in immunodeficiencies).

It is worth noting that it is almost impossible to diagnose herpes zoster before the rash appears. The pain that occurs (depending on the location) may resemble diseases of the heart, lungs, or nervous system. After the development of a characteristic rash - with unilateral localization of exudative elements along the nerves (monomorphic elements - vesicles of various sizes), as well as severe neurological pain - the diagnosis of herpes zoster is not difficult.

Shingles: photo

What shingles looks like in an adult, we offer you to view detailed photos skin rashes.

Complications

In case of severe clinical course and inadequate treatment, shingles can lead to serious complications:

The most common (up to 70%) is postherpetic neuralgia. Pain along the nerve remains for months, and for some it lasts for years, and the older the patient, the greater the chance that this complication will develop;
Paralysis manifested as a result of damage to the motor branches of the nerves;
Facial nerve paralysis and facial distortion to one side;
Pneumonia, duodenum, Bladder;
Eye lesions of varying severity;
Meningoencephalitis is extremely rare, but the most dangerous complication. In the period from 2 to 20 days from the onset of the disease, severe headache, photophobia, vomiting, there may be hallucinations and loss of consciousness.

Due to the risk of developing consequences, experts urge patients to refrain from self-medication at home and promptly seek help from specialized institutions.

Treatment of herpes zoster in humans

Uncomplicated cases are treated at home. Hospitalization is indicated for all people with suspected disseminated process, with damage to the eyes and brain.

In most cases, shingles in an adult can go away on its own without treatment. However, without the use of medications, there is a high probability of developing serious complications of the disease, as well as the inability to tolerate strong painful sensations in the acute and chronic phase. Therapy methods are aimed at accelerating recovery, reducing pain and preventing the consequences of herpes.

The treatment regimen for herpes zoster in humans is based on the use of the following drugs:

. Acyclovir, valacyclovir and famciclovir are used to treat shingles. When starting therapy within 72 hours from the appearance of the first rash, they can reduce the severity of pain, reduce the duration of the disease and the likelihood of postherpetic neuralgia. Famciclovir and valacyclovir have a more convenient regimen than acyclovir, but they are less studied and several times more expensive.
. Pain relief is one of the key points in the treatment of herpes zoster. Adequate pain relief makes it possible to breathe normally, move and reduce psychological discomfort. Common analgesics used: Ibuprofen, Ketoprofen, Dexketoprofen, etc.
Anticonvulsants. Anticonvulsants Typically used for epilepsy, they also have the ability to reduce neuropathic pain. For Herpes zoster, some of them can be used, 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 antivirals, to reduce mild to moderate symptoms. severe forms diseases. However, these drugs are not currently recommended for use in this disease.

Prescription of drug therapy is necessary primarily for those people who have a high risk of complications, as well as in cases of protracted disease. Drug therapy indicated for persons with immunodeficiencies and patients whose age has exceeded the 50-year barrier. The effectiveness of antiviral therapy in young and healthy people not proven.

When you have shingles, it is important not to panic. In most cases, timely antiviral treatment gives quick results and helps to avoid complications. However, neglect a visit to a specialist, especially if facial or trigeminal nerve, also not worth it.

Which doctor should I contact?

If blisters appear on the skin or mucous membranes, you should consult a dermatologist. In some cases, an additional examination by a neurologist is required. In case of long-term, severe, recurrent course, consultation with an immunologist and an infectious disease specialist is necessary.

Herpes zoster - infection, which has a common pathogen with chickenpox - Herpes zoster. Herpes zoster is more common among adults and is characterized by the appearance of a painful blistering rash along the nerve fibers. It often appears as if a stripe of rash encircles a person's torso - hence the name of this infection.

Incubation period

The incubation period is the period of time from the moment of infection with a viral agent until the appearance of clinical manifestations. Often this period has a clear time frame for each specific disease. The incubation period of herpes zoster can last as long as desired - months and years. The development of the disease itself is not associated with any virulent properties of the infectious agent. It is under the influence of certain external factors, reducing control immune system over the virus. In other words, the disease will manifest itself only when the immune system is weakened and herpes is activated in the nerve ganglia.

When first exposed to herpesvirus type 3, an uninfected person develops chickenpox. But after recovery, complete elimination (removal) of the pathogen from the body does not occur. Herpes permanently settles in the nerve ganglia of the spinal cord and cranial nerves. And how long it will stay there depends on how reliable the body’s defenses are.

It is believed that chickenpox leaves lifelong immunity. Indeed, repeated cases of chickenpox are extremely rare. When the virus is reactivated in the body, herpes zoster usually occurs.

The main reasons for the weakening of the human body’s defenses are as follows:

Prolonged excessive physical and psycho-emotional stress.
Lack of protein and vitamins in the diet.
Decreased immune defense in old age.
Artificial suppression of immunity when taking cytostatics and radiation therapy.
Congenital and acquired immunodeficiency conditions.

You can get this herpes infection several times during your life, but it may also happen that the incubation period of herpes zoster never ends and the disease does not manifest itself.

Duration of the disease

How long the disease will last depends on the general condition of the patient with herpes zoster, as well as on how responsibly he treats the treatment. The clinical picture of the disease includes the following stages:

Prodromal period. Characterized by general malaise, headache, and slight increase in body temperature. Pain, burning and itching also appears in the area of future rashes. This period lasts 2-4 days.
Actually the rash. During this period, patients usually receive a course of treatment. The disease can be treated for as long as the herpetic blisters are added. The average duration is 5-7 days.
Period of crust formation. Lasts about 10 days. The crusts pass, leaving behind pigmentation.

In total, the duration of the disease is from 2 to 4 weeks. A patient is considered infectious until the first crusts form. This should be taken into account when planning quarantine measures.

Patients with shingles are dangerous in terms of infection for children and adults who have not had chickenpox. For those who have recovered from the disease, such patients do not pose any danger.

Preventive actions

For people who have had chicken pox, prevention of herpes zoster mainly includes measures to strengthen the body's defenses, namely:

complete fortified diet;
avoiding hypothermia;
sufficient physical activity;
complete rest;
combating stress.

Those who have been spared chickenpox should take measures to protect themselves from infection. Persons with weakened immune systems should think about specific prevention - vaccination. If the disease occurs in a vaccinated person, it is treated quickly, easily and does not cause complications.

Features of herpes infection

The herpes virus, once it enters the body, remains in it forever. In the most unfavorable periods for human health, it certainly makes itself felt. And if it is impossible to get rid of it, then everyone can learn to prevent and successfully treat the infections it causes.

The second name for shingles is herpes zoster. The disease is provoked by the herpes virus type III Herpeszoster, which does not go away after chickenpox. nerve cells person, but flows into a latent form and does not manifest itself in any way until a certain time. Essentially, these two diseases are at different stages the same infection. If chicken pox is acute phase, then shingles is a relapse.

Shingles Facts:

According to statistics, up to 95% of the world's population are carriers of one or another herpes virus, one of the 8 known to modern science.
The incidence of relapse of Herpeszoster with manifestations in the form of herpes zoster is about 15%.
In 50% of cases, relapse in the form of herpes zoster occurs once and never occurs again.
In the remaining half of patients, signs of shingles can be lifelong, causing extreme discomfort and significantly impairing quality of life.
The disease mainly affects older people of both sexes, as well as people with HIV and oncology.
Herpes zoster may recur.
Children who come into contact with people with shingles develop typical chickenpox.

The Herpeszoster virus is unstable to external factors - it dies when elevated temperatures And ultraviolet irradiation, is easily destroyed by disinfectants, however, it can remain viable for a long time at low temperatures.

CAUSES

The reason for the reactivation of the virus is decreased general immunity. As a result, Herpeszoster, dormant in the cells of the spinal cord, moves along the nerve cells and causes a rash in the area of the skin for which the nerve endings affected by it are responsible.

Factors that reduce immunity:

Conditions of severe immunodeficiency - HIV, cancer, autoimmune, hematological diseases, diabetes.
Old age, accompanied by a slowdown in metabolic processes and a deficiency of the body's immune response.
Previous organ transplant operations, complex injuries.
Chronic liver diseases.
Taking certain types of drugs: corticosteroids, immunosuppressants that suppress natural defense mechanisms.
General loss of strength, overwork, stress, hypothermia.

The combination of several factors simultaneously significantly increases the risk of recurrence of the herpes virus in the form of herpes zoster.

CLASSIFICATION

The classification of herpes zoster is based on the differences in the clinical manifestations of the disease.

Forms of herpes zoster:

Gangliocutaneous. It has an acute onset, expressed in a sharp deterioration in general condition, an increase in temperature, and the appearance of pain at the sites of the future rash. Self-rash begins with small and very painful blisters filled with a transparent substance that becomes cloudy over time. The bubbles are localized in groups, always on one side of the body, on the surface of the area of the skin that is innervated by the affected nerve. After a few days, the bubbles burst and dry out to form crusts, which, after falling off, leave pinkish marks.
Ear and eye. Occurs if the facial trigeminal nerve is affected and is accompanied by severe symptoms. The rashes are located on the mucous membranes and skin of the nose, ears, and eyes. This causes unbearable pain and often provokes complications in the form of inflammatory diseases affected organs, for example, glaucoma, keratitis, otitis. The patient's general condition sharply worsens - body temperature rises, aches and pains occur in the muscles and joints.
Meningoencephalitis. A rare and extremely complex form, ending in human death in 60% of cases. Herpes zoster begins to manifest itself as symptoms of the gangliocutaneous form, usually in the intercostal space, less often in the area cervical region spinal column. After 1-2 weeks, the patient shows signs of severe brain damage: loss of consciousness, hallucinations, impaired coordination of movements, even possible.
Necrotic. One of the most severe forms of shingles, often associated with a bacterial infection. Accompanied by deep, long-healing lesions skin with the formation of necrosis, which can lead to the development of gangrene. During the regeneration process, deep scars and scars are formed.
Disseminated. It is characterized by a generalized localization of vesicular rashes over the entire surface of the body on both sides, as with chickenpox. It is difficult and can become one of the first manifestations of HIV infection in the human body.

The characteristics of rashes on the skin and mucous membranes can vary significantly, which causes the manifestation of atypical forms of the disease with an altered or blurred clinical picture.

Atypical types of herpes zoster:

Hemorrhagic - accompanied by the presence of difficult-to-heal rashes with bloody contents.
Bullous - characterized by the appearance of blisters large sizes arbitrary shape with uneven edges.
Abortive - rash blisters on the body may be completely absent, as well as pain.

SYMPTOMS

The disease always affects only people who have previously had chickenpox. The period from the moment the herpes virus enters the human body until the symptoms of shingles appear can be several years or even decades.

Symptoms of herpes zoster:

Prodromal period. In the initial period, the patient experiences a burning sensation and sharp pain at the site of future rashes, most often on the scalp - forehead, upper and lower jaws, back of the head, neck, intercostal surfaces, chest, back, shoulders, groin and buttocks. The general condition sharply worsens, the body temperature rises, the lymph nodes enlarge, weakness, and disorders of the gastrointestinal tract and bladder appear.
Period of rash. It begins after 2-4 days and depends on the form of the disease. The rashes characteristic of each manifestation of the disease initially look like pink spots up to 5 mm, after which groups of small bubbles with liquid contents begin to form on them, initially transparent, after 3-4 days they become cloudy, sometimes mixed with blood. The rash continues to appear for several days, new elements move to new areas of the skin and encircle the body, which is why the disease has this name. Sometimes rashes do not appear on the surface of the skin, only pain is present at the site of the affected nerve.
Period of residual effects.Occurs after the complete cessation of the appearance of new rashes, usually 2-3 weeks after the start of the process. It is characterized by the formation of crusts on the surface of healing blisters, which, after peeling, leave behind weak pigmentation or lightened areas of the skin.

Shingles rash localized on one side of the body, segmentally, in contrast to chickenpox, in which the rashes are located chaotically throughout the body.

The nature of the pain in acute form The disease can vary from patient to patient: some experience only mild discomfort, while for others, minor touches or even temperature fluctuations can cause unbearable burning and tingling. This pain is caused by a disruption in the functioning of nerve cells and an exacerbation of their sensitivity.

This symptom persists in 15-20% of people even after the skin has completely healed for several months or even years. This syndrome called postherpetic neuralgia and is explained by the natural duration of recovery of the affected nerve tissue.

DIAGNOSTICS

Diagnosis of the disease, as a rule, is not difficult; it is carried out by a dermatologist during examination of the patient. Clinical picture typical herpes zoster is usually quite informative, only at the very beginning, before the appearance of a characteristic rash, can it be confused with another viral disease. To confirm the diagnosis in case of doubt or when atypical forms lichen are used laboratory methods diagnostics

Tests for herpes zoster:

Polymerase chain reaction.
Immunofluorescence analysis.
Serological method.
Lymphoblastic transformation test (for babies in the womb).

One of the most common tests is the polymerase chain reaction, for which the contents of the vial and the patient’s blood are taken. The analysis allows you to identify the exact type of herpes virus through the isolation of its DNA and antibodies to the virus.

TREATMENT

Treatment for herpes zoster depends on the form and severity of the disease, as well as age and concomitant diseases patient. As a rule, young people with a stable immune system who do not have serious illnesses chronic diseases, receive only symptomatic treatment. And the virus itself is inactivated in them simply over time, usually in 2-3 weeks. Elderly patients and people with immunodeficiencies require more serious antiviral and other drugs. The virus often affects not only the skin, but also elements of the nervous system, so treatment is carried out not only by a dermatologist, but also by a neurologist and an infectious disease specialist.

Treatment for herpes zoster:

Pain relief - painkillers and non-steroidal anti-inflammatory drugs are prescribed.
Antiviral drugs are effective only in the first 5-6 days after the onset of the disease.
Relief and relief of itching - antihistamine and sedative groups of drugs.
If a bacterial infection develops, antibiotic therapy is prescribed.
Immunomodulators, complex vitamins.

To treat lesions on the skin, brilliant green, Castellani liquid, and potassium permanganate solution are used. However, you should not abuse them so as not to cause burns to inflamed sensitive skin.

Hormonal corticosteroids are not prescribed because they weaken the natural protective functions of the immune system and can in this case only harm the patient.

With long-term persistence of postherpetic neuralgia - severe pain syndrome- physiotherapy, acupuncture, plasmapheresis and antidepressants may be prescribed.

COMPLICATIONS

The herpes virus, which causes shingles, primarily affects the human nervous system. It significantly weakens the immune system and overall resistance of the body. Hence many serious side effects which this disease can lead to.

Complications caused by herpes zoster:

Pathomorphological changes in the brain - edema, hemorrhage.

Lesions of the peripheral nervous system - neuralgia, neuropathy.

Inflammation of brain tissue -, serous meningitis, hemiplegia.

Lesions of the spinal cord - herpetic myelitis.

Paralysis of the limbs and one side of the face - with damage to the motor and facial nerves.

Severe damage to the organs of vision and ear - with ophthalmic and ear forms of herpes zoster.

Disruption of the functioning of internal organs - lungs, liver, duodenum, bladder.

Suppuration of rashes, up to the development of gangrene.

Perennial pain at the sites of rashes after they have completely healed.

PREVENTION

There is no specific prevention herpes virus disease. It can only consist of maintaining the natural human immune system and increasing the body's resistance. This is facilitated by conducting healthy image life, refusal bad habits, active physical regime, adherence to rules healthy eating, adequate sleep, hardening, walks fresh air, avoidance of aggressive influence ultraviolet rays, harmonious psycho-emotional state of a person.

PROGNOSIS FOR RECOVERY

The prognosis is usually favorable character, especially for people with good immunity or those suffering from simple forms of herpes zoster. Such patients usually recover completely within 2-4 weeks from the onset of symptoms.

The exception is encephalitic forms of the disease. In this case, the most dire consequences are possible, up to the development of coma and death.

Elderly and senile people, as well as people with severe immunodeficiency, are prone to a long course of the disease, severe clinical manifestations, as well as frequent, sometimes lifelong, relapses.

Found a mistake? Select it and press Ctrl + Enter