How is shingles transmitted?
Herpes zoster (syn. - herpes zoster) is a secondary infection that develops only in people who have previously had chickenpox. Activation of the virus usually occurs against the background of a weakening of the cellular component of immunity and exposure to unfavorable factors, such as:
- Hypovitaminosis
- Taking hormonal medications
- Radiation or chemotherapy
- Blood diseases, diabetes, oncology
Women are more susceptible to relapses of herpes zoster, as well as carriers of the interleukin gene mutation and older people - for example, among adults aged 85 years, 50% of people have suffered at least one episode of the disease. And in patients with immunodeficiencies, in particular with HIV, the risk of reactivation of herpes type 3 increases 20 times compared to people with normal immune status.
Prevention
To avoid dermatous manifestations due to nervousness, the following preventive measures should be observed:
- protect yourself from stressful situations and prevent nervous disorders;
- regularly take walks in the fresh air;
- monitor the state of the body’s immune defense;
- be physically active, including sports;
- Always adhere to proper nutrition, avoid harmful and allergenic foods;
- carry out relaxing activities - massage, yoga, meditation;
- always set yourself up for positive emotions;
- eliminate all bad habits;
- Take sedatives immediately if nervous situations arise;
- observe all hygiene rules;
- fill life with positivity and laugh more often;
- take soothing baths based on essential oils;
- provide yourself with adequate rest after a hard day of work.
Positive changes have a positive effect on a person’s emotional and mental state. At the same time, it is recommended to carry out self-installations aimed at positive thinking.
Nervous ringworm may have a temporary manifestation, but sometimes the disease can develop for a long time and not respond to simple treatment methods.
The main task of this pathology is to eliminate the factors influencing the formation of dermatosis. Therefore, the basis of treatment is stabilization of the patient’s psycho-emotional state and elimination of foci of the disease.
Complete recovery from lichen that occurs on nerves depends on the correct approach to treatment and the accuracy of the diagnosis. When dealing with nervous rashes, it should be remembered that independent therapeutic measures can lead to a severe form of the disease and cause additional pathological processes.
How to relieve pain from shingles
The main symptom of herpes zoster, which distinguishes it from other infectious diseases with skin manifestations, is pain, which can occur both before the rash appears and after it has healed. For pain relief, the doctor prescribes non-steroidal anti-inflammatory drugs.
A common complication of herpes zoster is postherpetic neuralgia, a severe pain syndrome that lasts at least 120 days. Pain can bother a person for several months and even years after recovery. Postherpetic neuralgia develops mainly in older people - for example, about 50% of cases are recorded in patients over 60 years of age.
Features of treatment
When a diagnosis of lichen due to nerves is established and the type of dermatosis is determined, the patient is prescribed complex therapy. In this case, therapeutic actions should be aimed at eliminating:
- foci of skin disease;
- causes of pathological rashes - improvement of psycho-emotional state.
In this case, therapeutic actions are carried out by both a dermatologist and neurologists.
To eliminate the manifestations, the following are prescribed:
- antihistamines;
- anti-inflammatory, corticosteroid ointments;
- antiseptics.
Acyclovir and Zovirax are antiviral drugs for lichen.
To eliminate itching, Citrine, Erius, Suprastin or Fenistil help well. Increasing the body's defenses is of considerable importance. For this purpose, immunostimulants are used. The drug Zostevir has proven itself well.
Since nervous tension leads to a deficiency of vitamins in the body, preparations containing calcium, magnesium and potassium are often used.
During treatment, antiviral drugs are also used - Acyclovir or Zovirax.
To normalize the central nervous system, sedative medications are prescribed. The category of sedative medications depends on the severity of the patient’s psycho-emotional state.
When treating nervous lichen, sedatives are often prescribed.
Often used as sedatives:
- tincture of valerian and motherwort;
- "Persen";
- "Novo-Passit".
When dealing with stress, it is often recommended to take soothing herbal decoctions. Teas based on chamomile, lemon balm, mint and St. John's wort help well. Special herbal infusions also have a good effect.
.For severe nervous disorders, work with a psychologist is carried out. The treatment technique is selected by the doctor individually for each individual case.
Sometimes patients are advised to practice meditation or yoga. In particularly difficult cases, hypnosis treatment is sometimes required.
Also, during complex treatment, the patient’s bottom regimen is reviewed, which must include proper sleep and walks in the fresh air. It is recommended to eat only healthy foods enriched with vitamins and eliminate all bad habits.
Skin rashes due to nervousness sometimes go away on their own when the psycho-emotional state improves. But sometimes, with repeated stress disorders, the disease recurs and, if not treated correctly, can become chronic. Therefore, at the first manifestations of the disease, you should immediately consult a doctor for help. Self-medication in such cases is not acceptable, as it can aggravate the patient’s condition and cause serious complications.
Herpes zoster
The disease begins gradually, with general prodromal symptoms: headache, dyspeptic disorders, slight rise in temperature, chills and malaise. Later, pain and itching along the peripheral nerve trunks occur, and itching and burning of the skin is possible at the site of future rashes. These signs are subjective, and the intensity of manifestations may vary in each patient. The duration of the initial period is no more than 4 days, but in children this period is somewhat shorter than in adults.
After a short prodromal period, there is a sharp rise in temperature to febrile and symptoms of intoxication (headache and muscle pain, loss of appetite). At the same time, along one or more spinal ganglia, a painful skin rash appears in the form of pink spots, not prone to merging, with a diameter of 2-5 mm. But within 24 hours, against the background of exanthems, closely grouped vesicles with serous contents appear. The edges of the vesicles are uneven, the base is edematous and hyperemic. Depending on the state of the immune system and the severity of herpes zoster, enlargement and tenderness of the regional lymph nodes may be observed. In children, catarrhal inflammation of the upper respiratory tract (pharyngitis, laryngitis, rhinitis) is possible, which complicates the course of the disease.
Exanthems are localized in the areas of projection of the nerve trunk, and both unilateral and bilateral damage to the nerve ganglia is diagnosed. More common is a unilateral lesion, which is localized along the intercostal nerves and the trigeminal facial nerve. Cases where the nerve trunks of the limbs are affected with the development of neuritis are quite rare; Sometimes exanthemas are observed in the groin area.
With herpes zoster, as with chickenpox, rashes of various stages can be simultaneously seen, starting from a spot and ending with areas of hyperpigmentation after the vesicles resolve. After a few days, the swelling around the vesicles begins to subside, and along with it the hyperemia, the contents of the vesicles become cloudy, they gradually dry out, and serous crusts form in their place, after which a slight pigmentation of the skin is noted. At the same time, the temperature and intensity of intoxication syndromes decrease, and by the end of the third week recovery occurs.
Generalized form. Sometimes the generalized form of herpes zoster is confused with chickenpox, since rashes are noted not only along the nerve trunks, but also on other areas of the skin, as well as on the mucous membranes. If a generalized herpetic infection is diagnosed or the disease lasts more than 3 weeks, then patients should be examined for the presence of immunodeficiencies and the presence of oncological processes.
Abortive form. If herpes zoster occurs in an abortive manner, then an erythematous rash along the nerve trunks is characteristic, which quickly disappears without transforming into vesicles. The general condition of the patient does not suffer.
Bullous form. This form of herpes zoster is characterized by larger vesicles that merge into large blisters with serous contents. If the blood vessels are damaged, the contents become hemorrhagic, and when infection occurs, purulent. In severe cases, the blisters merge into continuous ribbons, which, when dry, can also become infected and subsequently form a dark necrotic scab. The severity of this form depends on the location of the exanthema: if the facial nerves are affected, then acute neuralgic pain, damage to the eyelids and cornea occur.
The duration of the disease in acute form is 2-3 weeks; with abortive – several days; and in case of complicated or protracted course – more than a month. The pain is burning, paroxysmal in nature, and its intensity increases at night. Local paresthesia and impaired skin sensitivity are also the most characteristic symptoms of herpes zoster.
There have been cases of damage to the oculomotor nerves, abdominal muscles and bladder sphincter. If serous meningitis develops, the degree of changes in the study of cerebrospinal fluid does not always correspond to the severity of meningeal symptoms. In the acute phase, encephalitis and meningoencephalitis are possible; polyradiculoneuropathy and acute myelopathy occur in occasional cases.
After treatment, persistent remission is observed, and relapses occur in a few percent of cases. With timely complex therapy, no residual effects are observed, but in some patients neuralgic pain persists for several years.
Causes and risk factors
The cause of shingles is the third type of herpes virus. This virus causes chickenpox. Chickenpox usually affects children; the disease is rare in adults. After chickenpox, the virus remains in the body for life.
It moves to the nerve ganglia, where it remains in an inactive state for a long time, without causing any symptoms. When the body weakens and is exposed to provoking factors, the virus becomes more active. It reaches the skin along the nerve fibers, where a rash forms. Moving along the nerve fibers, the virus destroys them, which is why pain occurs.
You cannot get shingles from another person. The disease will only occur if a person has had chickenpox and the virus remains in his body. Shingles is not transmitted by airborne droplets. But there is one nuance here. A person with shingles is dangerous to people who have not had chickenpox.
If a person with shingles comes into contact with a person who has not had chickenpox, the latter will develop chickenpox. But here you need quite close contact. The virus in lichen is found only in the skin and is not spread by airborne droplets.
Reasons for the activation of the virus:
- a sharp decrease in immunity - after a serious illness, with cancer, HIV infection;
- severe or frequent overheating - visiting a bathhouse or sauna, climate change;
- hypothermia;
- prolonged exposure to the sun or solarium;
- severe stress.
Shingles reoccurs extremely rarely. Relapses can occur in people with active autoimmune diseases or HIV infection without taking antiretroviral drugs. Repeated cases also occur in people with cancer, and the rash often corresponds to the location of the tumor. There is no chronic form of herpes zoster; this disease is always acute.
Shingles is classified according to the nature of its course:
- typical;
- atypical.
According to severity:
- light;
- moderate severity;
- heavy.
There are fulminant and protracted course of the disease. Shingles also occurs with or without complications.
Main symptoms of the disease
Herpes zoster mainly occurs on the body. At first it looks like pink spots. Soon they quickly become inflamed, turn red, and become covered with small blisters with transparent contents. Over time, the spots dry out and become crusty, and later they fall off.
The disease is characterized by severe attacks of pain, which can worsen at night.
Other signs of the disease:
- temperature rises to 39°C;
- painful rashes;
- headache;
- trembling and coldness in the body;
- runny nose (in children).
Information about herpes group viruses
Herpes viruses are widespread in the human population and have a wide variety of clinical manifestations, affecting various organs and tissues. Currently, 8 types of human herpesviruses are known, divided into 3 groups: α-herpesviruses - herpes simplex viruses type 1 and 2 (HSV-1, -2), varicella-zoster virus (VZV), β-herpesviruses: cytomegalovirus (CMV) ), human herpes virus type 6 (HHV-6), HHV-7 and γ-herpesviruses: Epstein–Barr virus (EBV) and HHV-8 (2). Studies have shown that 87% of those examined have specific IgG to the varicella zoster virus, which may indicate infection at an early age (1). In 2017, there were 4 deaths from chickenpox, 3 of which were children. The incidence rate of children and adults is increasing from year to yeariii. So the potential health threat concerns the majority.
In practice, doctors of many specialties quite often encounter the treatment of diseases caused by HSV types 1 and 2 (labial and genital herpes), VZV (varicella, herpes zoster), for which diagnostic and therapeutic methods have been developed and standardized. However, despite the presence of a large arsenal of antiviral drugs, the effectiveness of systemic therapy for recurrent herpes infection is often, alas, low. To achieve long-term remission in treatment, an integrated approach is important: drugs that directly affect the virus plus stimulation of antiviral immunity.
Herpes type 3 (VZV) is especially dangerous for pregnant women, as it negatively affects the fetus. The level of antibodies in the mother's blood is sometimes insufficient to protect the fetus; this is due to a decrease in immunity during pregnancy; drugs with an immunomodulatory effect may be required. Herpes zoster during pregnancy is a marker of the immune response: if chickenpox recurs, it is necessary to urgently take measures to prevent infection of the fetus. The degree of danger to the fetus depends on the duration of pregnancy and the titer of protective antibodies in the mother. Drugs that can be used for herpes zoster during pregnancy - VIFERON Gel, VIFERON Ointment.
What you need to know about diagnosis and treatment
Diagnosis of pityriasis rosea is based on taking the patient's medical history. To confirm or refute and analyze complex cases, a number of laboratory tests are prescribed. They include clinical examination of blood and urine. It is necessary to exclude syphilis and mycosis, therefore serological and microscopic studies are additionally carried out. If these methods do not provide enough information to verify the diagnosis, the patient is referred for a biopsy (biopsy histology).
Treatment for pityriasis rosea is not always required. The disease is prone to voluntary self-healing within 5 weeks. However, dermatosis should not be considered harmless. First of all, antipruritic therapy is required. For this purpose, topical glucocorticosteroid drugs and antihistamines are used externally. Ointments, gels, pastes cannot be used without a dermatologist's prescription. Otherwise, the rash may increase the extent of skin damage, covering new areas. Antibiotics and antiviral drugs may be prescribed depending on the indications. Ultraviolet therapy has a good effect.
