Shingles is an infectious disease caused by the neurodermatotropic virus Varicella Zoster, which affects the skin and nervous system. The same virus is the causative agent of chickenpox. In every person who has had chickenpox in childhood, the virus is stored in the body in a latent form and with normal immune status may not manifest itself for many years.
The prevalence of shingles
It is present in the body in 95 - 97% of the world's population. Most often, children under the age of 12 suffer from chickenpox. Shingles occurs equally often in both men and women. Based on many studies of Varicella Zoster, it can be argued that shingles is a recurrence of chickenpox.
It is diagnosed in 15 people out of 1000 at the age mainly after 50 years. In some patients, relapse occurs: in 2% with normal immunity and in 10% with immunodeficiency. According to statistics, every old man who has lived to 70 years old, develops herpes zoster. 20% of the population are ill.
Shingles causative agent - transmission routes
The causative agent is very unstable in the environment: when heated for 10 minutes, dies, in the same time - under the influence of ultraviolet radiation and antiviral drugs. At the same time, it tolerates cold well: it does not die even when frozen.
The main route of transmission of the herpes virus is by airborne droplets. You can also get infected by direct contact with liquid from vesicles with chickenpox or shingles. Upon contact of a child who has not previously had chickenpox with a person with shingles, infection will occur in 100% of cases. Clinical manifestations in an infected child will begin to develop in 2 to 3 weeks. The disease will proceed in the form of chicken pox. An adult cannot get infected from another adult, but his infection comes from a child with chickenpox.
Risk factors
Risk factors that are “triggering” for the awakening of Varicella Zoster are:
• taking drugs that cause immunodeficiency (hormonal drugs, immunosuppressants, chemotherapy);
• stress and overwork;
• vitamin deficiency;
• alcohol abuse;
• high insolation;
• pregnancy;
• high physical activity with insufficient rest;
• severe chronic or oncological diseases;
• radiation therapy;
• HIV AIDS.
A decrease in immunity is today considered the main cause of the development of herpes zoster.
Shingles - a mechanism for the development of pathology
Herpes zoster is characterized by unilateral skin rashes and intense pain.
After chickenpox, the zoster virus is stored in the cells of the nervous system. There are no clinical symptoms until the body is exposed to risk factors. The mechanisms of the transformation of the virus into "dormant" and then into active are not thoroughly studied and fully understood. It is assumed that the virus exits from the body of the neuron and moves along the long processes (axons). Upon reaching the end of the nerve, the virus provokes an inflammatory process in the area of the skin that is innervated by the affected nerve.
It is the pathological changes in nerve cells that occur under the destructive influence of the virus that cause the so-called "postherpetic neuralgia" - severe pain and intolerable itching at the lesion sites, which persist for a long time in patients.
Shingles - symptoms of the disease
With shingles, the symptoms of the disease at an early stage are itching and pain at the location of the virus-damaged neuron and its processes. These complaints appear 2 to 3 days before the appearance of changes on the skin. The arising intense pain sensations intensify and become unbearable at night, as well as from touch, cold, and other influences. The pain continues even after the disappearance of the rash, it is difficult to treat.
Also, symptoms of intoxication develop, proceeding according to the flu-like type: fever, severe weakness, headaches, general malaise, decreased appetite, nausea, and sometimes vomiting.
After 3 days, on the skin along the innervated nerve on one side (the process is one-sided), skin manifestations appear in the form of spots of different shapes. After another 4 days, papules are formed at the site of the spots, transforming into vesicles filled with liquid. Then the bubbles decrease, dry out, yellow crusts form in their place, which gradually disappear imperceptibly.
In severe cases, the lymph nodes are involved, they enlarge and become painful, the rash occupies large areas of the skin, can spread throughout the body, captures the mucous membranes - a generalized form. If the process continues to spread, pathological changes affect the dermis - the deep layers of the skin. Subsequently, cicatricial changes form at the site of primary rashes.
With the development of herpes zoster, the symptoms are excruciating intense pains that are poorly stopped by analgesics, they are disturbed for 2 weeks.
The average duration of the disease is 3 weeks.
Tinea versicolor - various forms
Eye shape
If the trigeminal nerve (its optic branch) is affected, the eyes suffer. The rash in this case is localized in the orbit. A complication may be damage to the cornea.
Ear shape
When involved in the process of the facial nerve with shingles, the symptoms of damage are manifested by itching and a rash on the auricle. A dangerous complication of this form is the inability to fully close the eyelids on the side of the lesion.
Bullous form
The resulting vesicles (vesicles) merge into bullae with hemorrhoidal contents.
The abortive form is the easiest. With shingles, the symptoms of this form are manifested only by papules. Bubbles do not form. It passes quickly and without complications.
Tinea versicolor - treatment
Herpes zoster at a young age with normal immune status in uncomplicated form passes without treatment on its own after 3 weeks. Mandatory treatment is necessary in case of immunodeficiency, if the infection has developed against the background of serious chronic diseases of the internal organs.
With shingles, the treatment is complex and includes: etiological - the effect on the pathogen;
• pathogenetic - on the mechanism of the development of the disease;
• symptomatic.
With shingles, treatment is aimed at performing the following tasks:
• reduction of rashes;
• reduction of intoxication;
• elimination of the risk of relapse;
• elimination of the risk of complications;
• restoration of immunity.
For this, several groups of drugs are used:
1. Antiviral - Acyclovir (Zovirax), Valtrex, Vectavir, Famvir This is the basis of treatment, their intake should begin with the appearance of the first signs, or as soon as the diagnosis becomes clear. This will significantly accelerate the regression of rashes, shorten the duration of the disease and reduce the frequency and intensity of postherpetic neuritis.
2. Introduction in the first 72 hours after contact with the patient antiviral gamma - globulin.
3. The combination of antiviral drugs with vaccination effectively stops the infection process. Vaccination prevents the development of the disease and facilitates the course of an existing disease.
4. Interferon inducers - have an antiviral effect, are able to induce the production of endogenous interferon (Amiksin, Neovir, etc.) Some drugs with a different purpose have the same properties (Decaris / Levomizole /, Dibazole, Vitamin B12 and etc.).
5. Local use of antiviral drugs in the form of creams and ointments accelerates the process of regression of rashes (Vectavir - Cream, Acyclovir).
6. NSAIDs are also used - non-steroidal anti-inflammatory drugscourse vitamin therapy.
From physiotherapeutic procedures, ultraviolet irradiation using quartz is effective. Throughout the course of treatment, it is necessary to exclude alcohol and bathing.
The prognosis for shingles is favorable except for the encephalitic form. At the first signs of shingles, you should immediately contact an infectious disease specialist. Since the complications are very serious, self-medication is dangerous. Alternative methods are aimed at increasing the immune status and reducing pain and are possible only as an addition to the main drug therapy.
