Herpes-Zoster带状疱疹.pptVIP

* * * * Herpes Zoster 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. Pathogen and Pathogenesis Pathogen Varicella-Zoster virus (VZV) is characterized by neurotropism and dermatotropism. 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 sensory nerve into the skin , showing neuralgia and clustered vesicles. Clinical manifestations Prodrome: headache and fever hyperaesthesia pain in the affected area. Features of lesions The eruption presents as papules and erythema in the dermatome. Over a few days, crops of clustered red papules form in a discontinuous band and quickly evolve to clear vesicles surrounded by erythema. The eruption may have few lesions or reach total confluence in the dermatome. Lesions may become hemorrhagic, necrotic, or bullous. The vesicles 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. Complications Postherpetic neuralgia(PHN) The pain persists after the skin lesions have healed, with the same quality as that of acute zoster pain. a month Ophthalmic Zoster Ocular involvement is most commonly in the form of uveitis and keratitis. Ramsay Hunt syndrome Results from involveme