Advances in the Treatment and Prevention of Herpes Zoste：在带状疱疹的治疗和预防的研究进展.pptVIP

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Advances in the Treatment and Prevention of Herpes Zoste：在带状疱疹的治疗和预防的研究进展.ppt

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Advances in the Treatment and Prevention of Herpes Zoste：在带状疱疹的治疗和预防的研究进展

Advances in the Treatment and Prevention of Herpes Zoster and Postherpetic Neuralgia Barbara Singer, D.O. Burden of Illness Have you ever been grabbed by a burning demon in your face?? I have.? Its called Shingles.? Shingles is a disease that strikes more then a half-million Americans every year. It took three days of blinding pain for someone in the medical profession to recognize what I had. Quote Rosemary Appleton zoster patient who developed post herpetic neuralgia www.uct.ac.za/depts/mmi/stannard/vzv-lp2.gif /.../pho/t235/T235833A.jpg Childhood Immunization Varicella zoster immunization occurs in children – long term protection unknown Adults have been administered 2 doses the VZV vaccine post household exposure with a 70% efficacy Risk of developing herpes zoster after disease vs. vaccination unknown Herpes Zoster (HZ) Painful or itching rash that is on one side of body or face with dermatomal distribution web.uct.ac.za/depts/mmi/jmoodie/vzv-clin.gif HZ risk Seropositive for VZV Advancing age 2.5 per 1,000 ages 20-50 Double 5 per 1,000 ages 50-60 Double 10 per 1,000 ages over 65 HZ risk Also due to: Immune compromise Stress Major depression Role of Immunity Normal/adequate anti-varicella zoster virus antibodies are present – not antibody mediated immunity Cell-mediated immunity Life-span VZV immunity Viral presence at dermal/epidermal layersprojects.mmi.mcgill.ca/dermatology/vesicle5.jpg Ascent up sensory nerves to sensory ganglionwww.merck.co.za/.../images/962_herpes_zoster.jpg DERMATOMESfaculty.valencia.cc.fl.us/.../dermatomes.jpg .mx/images/herpes_zoster.jpg Herpes Zoster Reactivation of dormant varicella zoster virus 2-3 out of 10 people in the USA will develop herpes zoster in their lifetime More than 1 million people each year Prodrome Headache Photophobia Malaise Dermatomal pain and itching can happen weeks before rash Viremia likely cause Rash Red Maculopapular Unilateral Dermatomal Typically T3-L4 Rash phase is contagious through direc