Shingles hurts

Shingles is an acute, contagious skin disease caused by the varicella-zoster virus. Clusters of blisters will appear on the affected skin, and they will be distributed in a band-like pattern along one side of the peripheral nerve. The patient had significant neuralgia, accompanied by enlargement of local lymph nodes. This disease is more common in spring and autumn. If the viruses in the body and the viruses that transmit to the peripheral nerves are completely eliminated, there will generally be no sequelae.

1. Concept

Herpes zoster is an acute infectious skin disease caused by the varicella-zoster virus. Children who are not immune to the virus develop chickenpox when infected. Some patients become carriers of the virus after being infected but do not develop symptoms.

2. Causes

Humans are the only host of the varicella-zoster virus. The virus enters the blood through the respiratory mucosa to form viremia, causing chickenpox or latent infection. The virus can then remain latent in the dorsal root ganglia of the spinal cord or the sensory ganglia of the cranial nerves for a long time. When the body is exposed to some kind of stimulus (such as trauma, fatigue, malignant tumors, or weakness after illness), which causes the body's resistance to decrease, the latent virus is activated and travels down the axons of the sensory nerves to the skin of the area innervated by the nerves, where it replicates and produces blisters. At the same time, the affected nerves become inflamed and necrotic, causing neuralgia. After recovery from this disease, more lasting immunity can be obtained, so it generally will not recur.

Symptoms

Before the rash occurs, there may be systemic symptoms such as mild fatigue, low fever, and poor appetite. The affected skin will feel burning or neuralgia, and there will be obvious pain sensitivity when touched, which lasts for 1 to 3 days. The rash may also occur without any prodromal symptoms. The most common sites are the areas innervated by the intercostal nerves, cervical nerves, trigeminal nerves and lumbar sacral nerves. The affected area often first develops erythema, soon followed by millet- to soybean-sized papules, which are clustered and not fused, and then quickly turn into blisters with tense and shiny blister walls, clear blister fluid, and a red halo around the periphery. The skin between clusters of blisters is normal. The lesions are arranged in a band-like pattern along a peripheral nerve, mostly on one side of the body, usually not exceeding the midline. Neuralgia is one of the characteristics of this disease.

4. Postherpetic neuralgia

This virus is neurotropic. After invading the sensory nerve endings of the skin, it can move along the nerves to the ganglia of the posterior roots of the spinal cord and lurk there. When the host's cellular immune function is low, such as when suffering from a cold, fever, systemic lupus erythematosus, and malignant tumors, the virus is stimulated again, causing inflammation and necrosis of the ganglia. At the same time, the reactivated virus can move along the peripheral nerve fibers to the skin to cause herpes and pain. The older the age, the more severe the neuralgia. If the viruses in the body and the viruses transmitted to the peripheral nerves are cleared from the body, there will be no sequelae. Otherwise, postherpetic neuralgia may occur.