带状疱疹物理课件

HerpesZoster11Definition

HerpeszosteriscausedbyVaricella-Zostervirus(VZV),classicallyoccurs

unilaterally

withinthedistributionofasensorynerve,beingcharacterizedby

clustered

vesicles

andconsiderable

neuralgia.2Definition2PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

3PathogenandPathogenesis3Pathogenesis

VZVcausesvaricellainchildhood,andestablisheslatencyinsensorygangliaafterthe

primaryinfection.

VZVmayreplicatelaterinlife,takingadvantageofthedeclineinimmunefunction,travelingdown

thesensorynerveintotheskin,showingneuralgiaandclusteredvesicles.4Pathogenesis4ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

5Clinicalmanifestations5Featuresoflesions

Theeruptionpresentsaspapulesanderythemainthedermatome.

Overafewdays,crops

of

clustered

redpapulesforminadiscontinuous

band

andquicklyevolveto

clearvesicles

surroundedbyerythema.6Featuresoflesions6

Theeruptionmayhavefewlesionsorreachtotalconfluenceinthedermatome.Lesionsmaybecomehemorrhagic,necrotic,orbullous.77

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.88ComplicationsPostherpeticneuralgia(PHN)

Thepainpersistsaftertheskinlesionshavehealed,withthesamequalityasthatofacutezosterpain.>amonth9Complications9OphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

10OphthalmicZoster10RamsayHuntsyndrome

ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.VZV.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.11RamsayHuntsyndrome11

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

1212DisseminatedHerpesZoster

Ageneralizedvaricelliformeruptionaccompanyingthe

segmental

eruption.Ithasbeendefinedasmorethan20lesionsoutsidetheaffecteddermatome.Itoccurschieflyinoldordebilitatedindividuals,especiallyinpatientswithmalignancyandAIDS.13DisseminatedHerpesZoster13DiagnosisandMisdiagnosisDiagnosisTypicallesions:cropsofclusteredvesiclessurroundedbyerythema,forminginadiscontinuousband,withenlargedregionallymphnodes.Thedistributionofasignaldorsalnerveroot.Obviousneuralgia14DiagnosisandMisdiagnosis14Misdiagnosis:

Painususllyprecedestheeruptionby3or4days,sometimesitmaybemisdiagnosedtootherdiseases,dependingondifferentpart.AppendicitisCholecystitisAnginapectoris15Misdiagnosis:15TreatmentBedrestAntivirivaltherapy:acyclovir(ACV)0.25timesdailyvalacyclovir(VCV)1.03timesdailyfamciclovir(FCV)0.53timesdaily

for7days16Treatment16VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.TTFD25mgtidVitB120.5mgimqdAnalgesic:aspirinindomethacin

17VitaminB:helptoreNerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%scl18Nerveblocks18Inconclusion:

DefinitionPathogenClinicalmanifestationsComplicationsDiagnosisandmisdiagnosisTreatment19Inconclusion:19Definition

HerpeszosteriscausedbyVZV,classicallyoccursunilaterallywithinthedistributionofasensorynerve,withthefeaturesofclusteredvesiclesandneuralgia.20Definition20Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.2121ClinicalmanifestationsProdromeTypicallesionsDistributionNeuralgia22Clinicalmanifestations22

ComplicationsPostherpeticneuralgia(PHN)OphthalmicZosterDisseminatedHerpesZosterRamsayHuntsyndrome23ComplicationsPostherpeticneurDiagnosisand