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Herpes Zoster
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Herpes Zoster is an acute infectious viral disease. It is an extremely painful condition. Herpes zoster is also known as Shingles or Zona. It is associated with vehicular eruptions of the skin or mucous membranes in the areas supplied by the affected sensory nerves.

Causes of Herpes Zoster

The virus causing this disease is the same as that of varicella of chicken pox, chiefly the V-Z virus. It is believed that herpes zoster is caused by reactivation of the latent V-Z virus, which had been acquired during a previous attack of chickenpox. Hence, we can say that a primary infection by the V-Z virus results clinically in chickenpox, while a recurrent infection results clinically in herpes zoster. However, Herpes zoster is not a result of a primary exogenous infection. It is sporadic in occurrence.

Herpes Zoster Infection

The disease is commonly seen in adult life. It affects males and females equally. Rarely, it is seen in children. Initially, the adult patient develops fever general malaise. There is pain and tenderness along the course of the involved sensory nerves and it is usually unilateral. Most commonly the trunk is affected.

Within a few days the patients develops a linear popular or vesicular eruption of the skin or mucosa, which is supplied by the affected nerves. After rupture of the vesicles, healing starts but in few cases secondary infection may occur and slows the process considerably. Sometimes, the herpes zoster, resemble the lesions of herpes simplex, but the two diseases can be separated because the zoster virus cannot be transmitted to animals but the simplex virus can be transmitted to the animals.

The triggering factors initiating the onset of an attack of herpes zoster are varies and may include (i) Trauma (ii) Development of Malignancy (iii) Local X-ray radiation (iv) Immunosuppressive therapy. It is a common infection in immuno compromised patients and those with certain malignancies egr Malignant lymphomas. These diseases can prove to be life threatening if the viscera become involved. However, many attacks begin for no particular reason, and they often occur dive to a decree in host resistance due to age.

Symptoms of Herpes Zoster

Herpes zoster may involve the face particularly due to infection of the trigeminal nerve. If the occurs on the skin areas, then it is usually unilateral and these skin areas are supplied by the ophthalmic, maxillary or mandibular nerves. Lesions of the oral mucosa are very common and in such cases extremely painful vesicles are found on the buccal mucosa, tongue, uvula, pharynx and larynx.

They generally rupture to leave the areas of erosion. One of the characteristic clinical features of the disease involving the face or oral cavity is the unilaterality of the lesions. If the lesions get enlarged, they extend upto the midline and stop suddenly.

A special type of Herpes Zoster infection may occur involving the external ear and oral mucosa and it has been termed as Hunt’s syndrome. The Clinical features of the Hunt’s syndrome includes facial paralysis, pain of the external auditory meatus, that is the external ear and pinna of the ear.

There may be vesicular eruptions occurring in the oral cavity and it may be accompanied with hoarseness of voice, tinnitus (ringing sounding the ear), vertigo and few other disturbances.

Treatment for Herpes Zoster

The newer anti-viral drugs are commonly used for the treatment of herpes zoster. Anti viral drugs, may be various types such as Acylvir, Vidarbine, etc. The preliminary results appear very promising. Dusting powder of Zinc oxide or Sulphathiazole may also be used. Vitamin B12 may be administered. Tzank test is commonly used for the diagnosis of Herpes zoster infection. Fluoroscent antibody staining technique, viral culture and cytologic smears and serologic diagnosis is also made. If the disease occurs in children under 15 years of age, then the disease has a very benign clinical course.



 


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