带状疱疹专题知识培训

带状疱疹专题知识培训带状疱疹专题知识培训第1页Definition

HerpeszosteriscausedbyVaricella-Zostervirus(VZV),classicallyoccurs

unilaterally

withinthedistributionofasensorynerve,beingcharacterizedby

clustered

vesicles

andconsiderable

neuralgia.带状疱疹专题知识培训第2页PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

带状疱疹专题知识培训第3页Pathogenesis

VZVcausesvaricellainchildhood,andestablisheslatencyinsensorygangliaafterthe

primaryinfection.

VZVmayreplicatelaterinlife,takingadvantageofthedeclineinimmunefunction,travelingdown

thesensorynerveintotheskin,showingneuralgiaandclusteredvesicles.带状疱疹专题知识培训第4页ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

带状疱疹专题知识培训第5页Featuresoflesions

Theeruptionpresentsaspapulesanderythemainthedermatome.

Overafewdays,crops

of

clustered

redpapulesforminadiscontinuous

band

andquicklyevolveto

clearvesicles

surroundedbyerythema.带状疱疹专题知识培训第6页

Theeruptionmayhavefewlesionsorreachtotalconfluenceinthedermatome.Lesionsmaybecomehemorrhagic,necrotic,orbullous.带状疱疹专题知识培训第7页

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.带状疱疹专题知识培训第8页ComplicationsPostherpeticneuralgia(PHN)

Thepainpersistsaftertheskinlesionshavehealed,withthesamequalityasthatofacutezosterpain.>amonth带状疱疹专题知识培训第9页OphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

带状疱疹专题知识培训第10页RamsayHuntsyndrome

ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.VZV.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.带状疱疹专题知识培训第11页

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

带状疱疹专题知识培训第12页DisseminatedHerpesZoster

Ageneralizedvaricelliformeruptionaccompanyingthe

segmental

eruption.Ithasbeendefinedasmorethan20lesionsoutsidetheaffecteddermatome.Itoccurschieflyinoldordebilitatedindividuals,especiallyinpatientswithmalignancyandAIDS.带状疱疹专题知识培训第13页DiagnosisandMisdiagnosisDiagnosisTypicallesions:cropsofclusteredvesiclessurroundedbyerythema,forminginadiscontinuousband,withenlargedregionallymphnodes.Thedistributionofasignaldorsalnerveroot.Obviousneuralgia带状疱疹专题知识培训第14页Misdiagnosis:

Painususllyprecedestheeruptionby3or4days,sometimesitmaybemisdiagnosedtootherdiseases,dependingondifferentpart.AppendicitisCholecystitisAnginapectoris带状疱疹专题知识培训第15页TreatmentBedrestAntivirivaltherapy:acyclovir(ACV)0.25timesdailyvalacyclovir(VCV)1.03timesdailyfamciclovir(FCV)0.53timesdaily

for7days带状疱疹专题知识培训第16页VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.TTFD25mgtidVitB120.5mgimqdAnalgesic:aspirinindomethacin

带状疱疹专题知识培训第17页NerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%scl带状疱疹专题知识培训第18页Inconclusion:

DefinitionPathogenClinicalmanifestationsComplicationsDiagnosisandmisdiagnosisTreatment带状疱疹专题知识培训第19页Definition

HerpeszosteriscausedbyVZV,classicallyoccursunilaterallywithinthedistributionofasensorynerve,withthefeaturesofclusteredvesiclesandneuralgia.带状疱疹专题知识培训第20页Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.带状疱疹专题知识培训第21页ClinicalmanifestationsProdromeTypicallesionsDistributionNeuralgia带状疱疹专题知识培训第22页

ComplicationsPostherpeticneuralgia(PHN)OphthalmicZosterDisseminatedHerpesZosterRamsayHuntsyndrome带状疱疹专题知识培训