带状疱疹物理课件

,单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,Herpes Zoster,1,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,.,2,Pathogen and Pathogenesis,Pathogen,Varicella-Zoster virus(VZV)is,characterized by neurotropism and,dermatotropism.,3,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.,4,Clinical manifestations,Prodrome:,headache and fever,hyperaesthesia,pain in the affected area.,5,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.,6,The eruption may have few,lesions or reach total confluence,in the dermatome.,Lesions may become,hemorrhagic,necrotic,or bullous.,7,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.,8,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,9,Ophthalmic Zoster,Ocular involvement is most,commonly in the form of uveitis,and keratitis.,10,Ramsay Hunt syndrome,Results from involvement of the facial and auditory nerves by the VZV.,The presenting features include:herpes auricularis,facial paralysis,and auditory symptoms.,VZV.,Herpetic inflammation of the geniculate ganglion is felt to be the cause of this syndrome.,The presenting features include:herpes auricularis,facial paralysis,and auditory symptoms.,11,Incomplete herpes zoster,There are may only neuralgia,and papuloid lesions but with,no blisters.,12,Disseminated Herpes Zoster,A generalized varicelliform eruption,accompanying the,segmental,eruption.,It has been defined as more than,20 lesions outside the affected,dermatome.,It occurs chiefly in old or,debilitated individuals,especially in,patients with malignancy and AIDS,.,13,Diagnosis and Misdiagnosis,Diagnosis,Typical lesions:,crops of clustered vesicles surrounded,by erythema,forming in a discontinuous,band,with enlarged regional lymph nodes.,The distribution of a signal dorsal nerve root.,Obvious neuralgia,14,Misdiagnosis:,Pain ususlly precedes the eruption,by 3 or 4 days,sometimes it,may be misdiagnosed to other,diseases,depending on different part.,Appendicitis,Cholecystitis,Angina pectoris,15,Treatment,Bed rest,Antivirival therapy:,acyclovir (ACV)0.2 5 times daily,valacyclovir(VCV)1.0 3 times daily,famciclovir(FCV)0.5 3 times daily,for 7 days,16,Vitamin B:help to relief the inflammation of the involved nerve and relief the pain.,TTFD 25mg tid,VitB12 0.5mg im qd,Analgesic:aspirin,indomethacin,17,Nerve blocks,Improving immune function:,transfer factor(TF),Systemic corticosteroid therapy:,prednisone 10mg tid,Physical therapy,Topical therapy:5%scl,18,In conclusion:,Definition,Pathogen,Clinical manifestations,Complications,Diagnosis and misdiagnosis,Treatment,19,Definition,Herpes zoster is caused by,VZV,classically occurs unilaterally,within the distribution of a sensory,nerve,with the features of,clustered vesicles and neuralgia.,20,Pathogen,Varicella-Zoster virus(VZV)is,characterized by neurotropism and,dermatotropism.,21,Clinical manifestations,Prodrome,Typical lesions,Distribution,Neuralgia,22,Complications,Postherpetic neuralgia(PHN),Ophthalmic Zoster,Disseminated Herpes Zoster,Ramsay Hunt syndrome,23,Diagnosis and Misdiagnosis,Treatment,Bed rest,Antivirival therapy,Vitamin B,Analgesic,Nerve blocks,24,Improving immune function,Systemic corticosteroid therapy,Physical therapy,Topical therapy,25,Thank you,26,