皮肤性病学带状疱疹英文教学培训课件

1、Definition Herpes zoster is caused by Varicella - Zoster virus (VZV) , classically occurs unilaterally within the distribution of a sensory nerve, being characterized by clustered vesicles and considerable neuralgia.Definition Pathogen and Pathogenesis Pathogen Varicella-Zoster virus (VZV) is charac

2、terized by neurotropism and dermatotropism. Pathogen and Pathogenesis Pathogenesis VZV causes varicella in childhood , and establishes latency in sensory ganglia after the primary infection. VZV may replicate later in life, taking advantage of the decline in immune function, traveling down the senso

3、ry nerve into the skin , showing neuralgia and clustered vesicles. Pathogenesis Clinical manifestationsProdrome: headache and fever hyperaesthesia pain in the affected area. Clinical manifestationsFeatures of lesions The eruption presents as papules and erythema in the dermatome. Over a few days, cr

4、ops of clustered red papules form in a discontinuous band and quickly evolve to clear vesicles surrounded by erythema.Features of lesions The eruption may have few lesions or reach total confluence in the dermatome. Lesions may become hemorrhagic, necrotic, or bullous.皮肤性病学带状疱疹英文教学培训课件 The vesicles

5、slowly become pustulars, and rupture to form crusts , which separate in two to four weeks, often with scarring. The regional lymph nodes are enlarged and tender. ComplicationsPostherpetic neuralgia(PHN) The pain persists after the skin lesions have healed, with the same quality as that of acute zost

6、er pain. a monthComplicationsOphthalmic Zoster Ocular involvement is most commonly in the form of uveitis and keratitis. Ophthalmic ZosterRamsay Hunt syndrome Results from involvement of the facial and auditory nerves by the VZV. The presenting features include : herpes auricularis, facial paralysis

7、, and auditory symptoms. VZV. Herpetic inflammation of the geniculate ganglion is felt to be the cause of this syndrome. The presenting features include : herpes auricularis, facial paralysis, and auditory symptoms.Ramsay Hunt syndrome Incomplete herpes zoster There are may only neuralgia and papulo

8、id lesions but with no blisters. 皮肤性病学带状疱疹英文教学培训课件Disseminated Herpes Zoster A generalized varicelliform eruption accompanying the segmental eruption. It has been defined as more than 20 lesions outside the affected dermatome. It occurs chiefly in old or debilitated individuals, especially in patien

9、ts with malignancy and AIDS.Disseminated Herpes ZosterDiagnosis and MisdiagnosisDiagnosis Typical lesions: crops of clustered vesicles surrounded by erythema, forming in a discontinuous band, with enlarged regional lymph nodes.The distribution of a signal dorsal nerve root. Obvious neuralgiaDiagnosi

10、s and MisdiagnosisMisdiagnosis: Pain ususlly precedes the eruption by 3 or 4 days, sometimes it may be misdiagnosed to other diseases, depending on different part. Appendicitis Cholecystitis Angina pectorisMisdiagnosis: TreatmentBed restAntivirival therapy: acyclovir (ACV) 0.2 5 times daily valacycl

11、ovir(VCV) 1.0 3 times daily famciclovir (FCV) 0.5 3 times daily for 7 daysTreatmentVitamin B: help to relief the inflammation of the involved nerve and relief the pain. TTFD 25mg tid VitB12 0.5mg im qdAnalgesic: aspirin indomethacin Vitamin B: help to reNerve blocksImproving immune function: transfe

12、r factor (TF)Systemic corticosteroid therapy: prednisone 10mg tidPhysical therapy Topical therapy: 5% sclNerve blocksIn conclusion: Definition Pathogen Clinical manifestations Complications Diagnosis and misdiagnosis TreatmentIn conclusion:Definition Herpes zoster is caused by VZV, classically occur

13、s unilaterally within the distribution of a sensory nerve, with the features of clustered vesicles and neuralgia.Definition Pathogen Varicella-Zoster virus (VZV) is characterized by neurotropism and dermatotropism. 皮肤性病学带状疱疹英文教学培训课件Clinical manifestationsProdromeTypical lesionsDistributionNeuralgiaClinical manifestations ComplicationsPostherpetic neuralgia(PHN)Ophthalmic ZosterDisseminated Herpes ZosterRamsay Hunt syndromeComplicationsPostherpetic neurDiagnosis and MisdiagnosisTreatment Bed re