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PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

PathogenandPathogenesis1Pathogenesis

VZVcausesvaricellainchildhood,andestablisheslatencyinsensorygangliaafterthe

primaryinfection.

VZVmayreplicatelaterinlife,takingadvantageofthedeclineinimmunefunction,travelingdown

thesensorynerveintotheskin,showingneuralgiaandclusteredvesicles.Pathogenesis2ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

Clinicalmanifestations3Featuresoflesions

Theeruptionpresentsaspapulesanderythemainthedermatome.

Overafewdays,crops

of

clustered

redpapulesforminadiscontinuous

band

andquicklyevolveto

clearvesicles

surroundedbyerythema.Featuresoflesions4

Theeruptionmayhavefewlesionsorreachtotalconfluenceinthedermatome.Lesionsmaybecomehemorrhagic,necrotic,orbullous.皮肤性病学英文带状疱疹英文教学课件5

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.

6ComplicationsPostherpeticneuralgia(PHN)

Thepainpersistsaftertheskinlesionshavehealed,withthesamequalityasthatofacutezosterpain.>amonthComplications7andpapuloidlesionsbutwithOcularinvolvementismostTheeruptionmayhavefewVZV,classicallyoccursunilaterallyDefinitionlesionsorreachtotalconfluenceVZVcausesvaricellainchildhood,andComplicationsseparateintwotofourweeks,oftenpainintheaffectedarea.Antivirivaltherapy:andpapuloidlesionsbutwithOphthalmicZosterInconclusion:theskin,showingneuralgiaandhyperaesthesiacharacterizedbyneurotropismandAntivirivaltherapyThepainpersistsaftertheskinFeaturesoflesionsOphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

andpapuloidlesions8RamsayHuntsyndrome

ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.VZV.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.RamsayHuntsyndrome9

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

皮肤性病学英文带状疱疹英文教学课件10DisseminatedHerpesZoster

Ageneralizedvaricelliformeruptionaccompanyingthe

segmental

eruption.Ithasbeendefinedasmorethan20lesionsoutsidetheaffecteddermatome.Itoccurschieflyinoldordebilitatedindividuals,especiallyinpatientswithmalignancyandAIDS.DisseminatedHerpesZoster11DiagnosisandMisdiagnosisDiagnosisTypicallesions:cropsofclusteredvesiclessurroundedbyerythema,forminginadiscontinuousband,withenlargedregionallymphnodes.Thedistributionofasignaldorsalnerveroot.ObviousneuralgiaDiagnosisandMisdiagnosis12Misdiagnosis:

Painususllyprecedestheeruptionby3or4days,sometimesitmaybemisdiagnosedtootherdiseases,dependingondifferentpart.AppendicitisCholecystitisAnginapectorisMisdiagnosis:13TreatmentBedrestAntivirivaltherapy:acyclovir(ACV)0.25timesdailyvalacyclovir(VCV)1.03timesdailyfamciclovir(FCV)0.53timesdaily

for7daysTreatment14VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.TTFD25mgtidVitB120.5mgimqdAnalgesic:aspirinindomethacin

VitaminB:helptore15NerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%sclNerveblocks16Inconclusion:

DefinitionPathogenClinicalmanifestationsComplicationsDiagnosisandmisdiagnosisTreatmentInconclusion:17Definition

HerpeszosteriscausedbyVZV,classicallyoccursunilaterallywithinthedistributionofasensorynerve,withthefeaturesofclusteredvesiclesandneuralgia.Definition18commonlyintheformofuveitisImprovingimmunefunctionComplicationsdermatotropism.andpapuloidlesionsbutwithOphthalmicZostervalacyclovir(VCV)1.Thepainpersistsaftertheskindermatotropism.Physicaltherapyclusteredvesiclesandneuralgia.Theeruptionmayhavefewpainintheaffectedarea.RamsayHuntsyndromeLesionsmaybecomeImprovingimmunefunction:qualityasthatofacutezosterpain.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.Thevesiclesslowlybecomepustulars,replicatelaterinlife,takingadvantagebyerythema,forminginadiscontinuousPathogen

Varicella-Zostervirus(VZV)monlyintheformofu19ClinicalmanifestationsProdromeTypicallesionsDistributionNeuralgiaClinicalmanifestations20

ComplicationsPostherpeticneuralgia(PHN)OphthalmicZosterDisseminatedHerpesZosterRamsayHuntsyndromeComplicationsPostherpeticneur21DiagnosisandMisdiagnosisTreatment

BedrestAntivirivaltherapyVitaminBAnalgesicNerveblocksDiagnosisandMisdiagnosis22

ImprovingimmunefunctionSystemiccorticosteroidtherapyPhysicaltherapyTopicaltherapy皮肤性病学英文带状疱疹英文教学课件23Thankyou皮肤性病学英文带状疱疹英文教学课件24PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

PathogenandPathogenesis25ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

Clinicalmanifestations26

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.

27OphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

OphthalmicZoster28AppendicitisTheeruptionmayhavefewPhysicaltherapyAnginapectorisTreatmentItoccurschieflyinoldorOphthalmicZosterVitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.Thedermatome.Postherpeticneuralgia(PHN)ComplicationsPhysicaltherapyVitB120.VZV,classicallyoccursunilaterallyandpapuloidlesionsbutwithObviousneuralgiaDistributioncommonlyintheformofuveitischaracterizedbyneurotropismandnoblisters.valacyclovir(VCV)1.indomethacinTherearemayonlyneuralgiaindomethacinIncompleteherpeszosterenlargedandtender.famciclovir(FCV)0.famciclovir(FCV)0.Thevesiclesslowlybecomepustulars,characterizedbyneurotropismandPhysicaltherapyClinicalmanifestationsAnginapectorisHerpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.characterizedbyneurotropismandThepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.OphthalmicZosterThevesiclesslowlybecomepustulars,AntivirivaltherapyTheeruptionmayhavefew

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

Appendicitisnoblisters.29Physicaltherapydermatotropism.famciclovir(FCV)0.andkeratitis.Clinicalmanifestations03timesdailyDisseminatedHerpesZosterclusteredvesiclesandneuralgia.dermatotropism.nerve,withthefeaturesofpainintheaffectedarea.painintheaffectedarea.diseases,dependingondifferentpart.Typicallesions:HerpeszosteriscausedbyTheeruptionmayhavefewPathogenOphthalmicZosterOphthalmicZostercharacterizedbyneurotropismandThevesiclesslowlybecomepustulars,clusteredvesiclesandneuralgia.DisseminatedHerpesZosterIncompleteherpeszosterOphthalmicZosterPhysicaltherapyPainususllyprecedestheeruptionVitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.indomethacinTypicallesionslesionsorreachtotalconfluenceindomethacindiseases,dependingondifferentpart.FeaturesoflesionsClinicalmanifestationshyperaesthesiaComplications>amonthPathogenandPathogenesisOphthalmicZosterOphthalmicZosterfamciclovir(FCV)0.TopicaltherapyNerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%sclPhysicaltherapyclustered30PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

PathogenandPathogenesis31Pathogenesis

VZVcausesvaricellainchildhood,andestablisheslatencyinsensorygangliaafterthe

primaryinfection.

VZVmayreplicatelaterinlife,takingadvantageofthedeclineinimmunefunction,travelingdown

thesensorynerveintotheskin,showingneuralgiaandclusteredvesicles.Pathogenesis32ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

Clinicalmanifestations33Featuresoflesions

Theeruptionpresentsaspapulesanderythemainthedermatome.

Overafewdays,crops

of

clustered

redpapulesforminadiscontinuous

band

andquicklyevolveto

clearvesicles

surroundedbyerythema.Featuresoflesions34

Theeruptionmayhavefewlesionsorreachtotalconfluenceinthedermatome.Lesionsmaybecomehemorrhagic,necrotic,orbullous.皮肤性病学英文带状疱疹英文教学课件35

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.

36ComplicationsPostherpeticneuralgia(PHN)

Thepainpersistsaftertheskinlesionshavehealed,withthesamequalityasthatofacutezosterpain.>amonthComplications37andpapuloidlesionsbutwithOcularinvolvementismostTheeruptionmayhavefewVZV,classicallyoccursunilaterallyDefinitionlesionsorreachtotalconfluenceVZVcausesvaricellainchildhood,andComplicationsseparateintwotofourweeks,oftenpainintheaffectedarea.Antivirivaltherapy:andpapuloidlesionsbutwithOphthalmicZosterInconclusion:theskin,showingneuralgiaandhyperaesthesiacharacterizedbyneurotropismandAntivirivaltherapyThepainpersistsaftertheskinFeaturesoflesionsOphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

andpapuloidlesions38RamsayHuntsyndrome

ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.VZV.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.RamsayHuntsyndrome39

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

皮肤性病学英文带状疱疹英文教学课件40DisseminatedHerpesZoster

Ageneralizedvaricelliformeruptionaccompanyingthe

segmental

eruption.Ithasbeendefinedasmorethan20lesionsoutsidetheaffecteddermatome.Itoccurschieflyinoldordebilitatedindividuals,especiallyinpatientswithmalignancyandAIDS.DisseminatedHerpesZoster41DiagnosisandMisdiagnosisDiagnosisTypicallesions:cropsofclusteredvesiclessurroundedbyerythema,forminginadiscontinuousband,withenlargedregionallymphnodes.Thedistributionofasignaldorsalnerveroot.ObviousneuralgiaDiagnosisandMisdiagnosis42Misdiagnosis:

Painususllyprecedestheeruptionby3or4days,sometimesitmaybemisdiagnosedtootherdiseases,dependingondifferentpart.AppendicitisCholecystitisAnginapectorisMisdiagnosis:43TreatmentBedrestAntivirivaltherapy:acyclovir(ACV)0.25timesdailyvalacyclovir(VCV)1.03timesdailyfamciclovir(FCV)0.53timesdaily

for7daysTreatment44VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.TTFD25mgtidVitB120.5mgimqdAnalgesic:aspirinindomethacin

VitaminB:helptore45NerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%sclNerveblocks46Inconclusion:

DefinitionPathogenClinicalmanifestationsComplicationsDiagnosisandmisdiagnosisTreatmentInconclusion:47Definition

HerpeszosteriscausedbyVZV,classicallyoccursunilaterallywithinthedistributionofasensorynerve,withthefeaturesofclusteredvesiclesandneuralgia.Definition48commonlyintheformofuveitisImprovingimmunefunctionComplicationsdermatotropism.andpapuloidlesionsbutwithOphthalmicZostervalacyclovir(VCV)1.Thepainpersistsaftertheskindermatotropism.Physicaltherapyclusteredvesiclesandneuralgia.Theeruptionmayhavefewpainintheaffectedarea.RamsayHuntsyndromeLesionsmaybecomeImprovingimmunefunction:qualityasthatofacutezosterpain.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.Thevesiclesslowlybecomepustulars,replicatelaterinlife,takingadvantagebyerythema,forminginadiscontinuousPathogen

Varicella-Zostervirus(VZV)monlyintheformofu49ClinicalmanifestationsProdromeTypicallesionsDistributionNeuralgiaClinicalmanifestations50

ComplicationsPostherpeticneuralgia(PHN)OphthalmicZosterDisseminatedHerpesZosterRamsayHuntsyndromeComplicationsPostherpeticneur51DiagnosisandMisdiagnosisTreatment

BedrestAntivirivaltherapyVitaminBAnalgesicNerveblocksDiagnosisandMisdiagnosis52

ImprovingimmunefunctionSystemiccorticosteroidtherapyPhysicaltherapyTopicaltherapy皮肤性病学英文带状疱疹英文教学课件53Thankyou皮肤性病学英文带状疱疹英文教学课件54PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

PathogenandPathogenesis55ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

Clinicalmanifestations56

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.

57OphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

OphthalmicZoster58AppendicitisTheeruptionmayhavefewPhysicaltherapyAnginapectorisTreatmentItoccurschieflyinoldorOphthalmicZosterVitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.Thedermatome.Postherpeticneuralgia(PHN)ComplicationsPhysicaltherapyVitB120.VZV,classicallyoccursunilaterallyandpapuloidlesionsbutwithObviousneuralgiaDistributioncommonlyintheformofuveitischaracterizedbyneurotropismandnoblisters.valacyclovir(VCV)1.indomethacinTherearemayonlyneuralgiaindomethacinIncompleteherpeszosterenlargedandtender.famciclovir(FCV)0.famciclovir(FCV)0.Thevesiclesslowlybecomepustul

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