1、文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。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.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Pathogen a
2、nd Pathogenesis Pathogen Varicella-Zoster virus(VZV)is characterized by neurotropism and dermatotropism.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Pathogenesis VZV causes varicella in childhood,and establishes latency in sensory ganglia after the primary infection.VZV may replicate later in life,taking
3、advantage of the decline in immune function,traveling down the sensory nerve into the skin,showing neuralgia and clustered vesicles.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical manifestationsProdrome:l headache and feverl hyperaesthesial pain in the affected area.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站
4、或本人删除。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.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。The eruption may have few lesions or
5、 reach total confluence in the dermatome.Lesions may become hemorrhagic,necrotic,or bullous.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。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.
6、文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ComplicationsPostherpetic neuralgia(PHN)The pain persists after the skin lesions have healed,with the same quality as that of acute zoster pain.a month文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Ophthalmic Zoster Ocular involvement is most commonly in the form of uv
7、eitis and keratitis.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Ramsay Hunt syndrome l Results from involvement of the facial and auditory nerves by the VZV.l The presenting features include:herpes auricularis,facial paralysis,and auditory symptoms.VZV.Herpetic inflammation of the geniculate ganglion is
8、felt to be the cause of this syndrome.The presenting features include:herpes auricularis,facial paralysis,and auditory symptoms.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Incomplete herpes zoster There are may only neuralgia and papuloid lesions but with no blisters.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删
9、除。Disseminated Herpes Zosterl A generalized varicelliform eruption accompanying the segmental eruption.l It has been defined as more than 20 lesions outside the affected dermatome.l It occurs chiefly in old or debilitated individuals,especially in patients with malignancy and AIDS.文档仅供参考，不能作为科学依据，请勿
10、模仿；如有不当之处，请联系网站或本人删除。Diagnosis and MisdiagnosisDiagnosis lTypical lesions:crops of clustered vesicles surrounded by erythema,forming in a discontinuous band,with enlarged regional lymph nodes.lThe distribution of a signal dorsal nerve root.l Obvious neuralgia文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Mi
11、sdiagnosis: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文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。TreatmentlBed restlAntivirival therapy:acyclovir (ACV)0.2 5 times daily valacyc
12、lovir(VCV)1.0 3 times daily famciclovir(FCV)0.5 3 times daily for 7 days文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。lVitamin B:help to relief the inflammation of the involved nerve and relief the pain.TTFD 25mg tid VitB12 0.5mg im qdlAnalgesic:aspirin indomethacin 文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。l
13、Nerve blockslImproving immune function:transfer factor(TF)lSystemic corticosteroid therapy:prednisone 10mg tidlPhysical therapy lTopical therapy:5%scl文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。In conclusion:l Definition Pathogenl Clinical manifestations Complicationsl Diagnosis and misdiagnosis Treatmen
14、t文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。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.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Pathogen Varicella-Zoster virus(VZV)is characteriz
15、ed by neurotropism and dermatotropism.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Clinical manifestationsProdromeTypical lesionsDistributionNeuralgia文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ComplicationsPostherpetic neuralgia(PHN)Ophthalmic ZosterDisseminated Herpes ZosterRamsay Hunt syndrome文档仅供参考，不能作为科学依
16、据，请勿模仿；如有不当之处，请联系网站或本人删除。Diagnosis and MisdiagnosisTreatmentl Bed restlAntivirival therapyl Vitamin Bl Analgesicl Nerve blocks文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。l Improving immune functionl Systemic corticosteroid therapy l Physical therapy l Topical therapy文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Thank you
