皮肤性病学英文带状疱疹英文教学培训课程课件.pptx

1、Pathogen and Pathogenesis Pathogen Varicella-Zoster virus(VZV)is characterized by neurotropism and dermatotropism.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 i

2、mmune function,traveling down the sensory nerve into the skin,showing neuralgia and clustered vesicles.Clinical manifestationsProdrome:l headache and feverl hyperaesthesial pain in the affected area.Features of lesions The eruption presents as papules and erythema in the dermatome.Over a few days,cr

3、ops of clustered red papules form in a discontinuous band and quickly evolve to clear vesicles surrounded by erythema.The eruption may have few lesions or reach total confluence in the dermatome.Lesions may become hemorrhagic,necrotic,or bullous.The vesicles slowly become pustulars,and rupture to fo

4、rm crusts,which separate in two to four weeks,often with scarring.The regional lymph nodes are enlarged and tender.ComplicationsPostherpetic neuralgia(PHN)The pain persists after the skin lesions have healed,with the same quality as that of acute zoster pain.a monthOphthalmic Zoster Ocular involveme

5、nt is most commonly in the form of uveitis and keratitis.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 fe

6、lt to be the cause of this syndrome.The presenting features include:herpes auricularis,facial paralysis,and auditory symptoms.Incomplete herpes zoster There are may only neuralgia and papuloid lesions but with no blisters.Disseminated Herpes Zosterl A generalized varicelliform eruption accompanying

7、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.nerve,with the features ofPostherpetic neuralgia(PHN)PathogenMisdiagnosis:Herpes zoster is caused

8、byhyperaesthesiaFeatures of lesionsdermatotropism.There are may only neuralgiaHerpetic inflammation of the geniculate ganglion is felt to be the cause of this syndrome.for 7 daysFeatures of lesionsPostherpetic neuralgia(PHN)Results from involvement of the facial and auditory nerves by the VZV.Topica

9、l therapy:5%sclThe pain persists after the skinestablishes latency in sensory gangliaand keratitis.Angina pectoriscommonly in the form of uveitisDiagnosis and MisdiagnosisDiagnosis lTypical lesions:crops of clustered vesicles surrounded by erythema,forming in a discontinuous band,with enlarged regio

10、nal lymph nodes.lThe distribution of a signal dorsal nerve root.l Obvious neuralgiaMisdiagnosis: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 pectorisTreatmentlBed restlAntivirival th

11、erapy:acyclovir (ACV)0.2 5 times daily valacyclovir(VCV)1.0 3 times daily famciclovir(FCV)0.5 3 times daily for 7 dayslVitamin B:help to relief the inflammation of the involved nerve and relief the pain.TTFD 25mg tid VitB12 0.5mg im qdlAnalgesic:aspirin indomethacin lNerve blockslImproving immune fu

12、nction:transfer factor(TF)lSystemic corticosteroid therapy:prednisone 10mg tidlPhysical therapy lTopical therapy:5%sclIn conclusion:v Definition Pathogenv Clinical manifestations Complicationsv Diagnosis and misdiagnosis TreatmentDefinition Herpes zoster is caused by VZV,classically occurs unilatera

13、lly within the distribution of a sensory nerve,with the features of clustered vesicles and neuralgia.Pathogen Varicella-Zoster virus(VZV)is characterized by neurotropism and dermatotropism.Clinical manifestationsProdromeTypical lesionsDistributionNeuralgia ComplicationsPostherpetic neuralgia(PHN)Oph

14、thalmic ZosterDisseminated Herpes ZosterRamsay Hunt syndromeDiagnosis and MisdiagnosisTreatmentl Bed restlAntivirival therapyl Vitamin Bl Analgesicl Nerve blockstransfer factor(TF)A generalized varicelliform eruptionVaricella-Zoster virus(VZV)iswith scarring.enlarged and tender.DistributionPostherpe

15、tic neuralgia(PHN)Misdiagnosis:Physical therapyThe pain persists after the skinPathogen and PathogenesisPain ususlly precedes the eruptiondermatotropism.quality as that of acute zoster pain.enlarged and tender.Diagnosis and MisdiagnosisOphthalmic Zostertransfer factor(TF)VZV,classically occurs unila

16、terallycommonly in the form of uveitisl Improving immune functionl Systemic corticosteroid therapy l Physical therapy l Topical therapy Thank youPathogen and Pathogenesis Pathogen Varicella-Zoster virus(VZV)is characterized by neurotropism and dermatotropism.Clinical manifestationsProdrome:l headach

17、e and feverl hyperaesthesial pain in the affected area.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.Ophthalmic Zoster Ocular involvement is most commonly in the form of uveitis

18、 and keratitis.Incomplete herpes zoster There are may only neuralgia and papuloid lesions but with no blisters.Pathogen and Pathogenesistransfer factor(TF)indomethacinPhysical therapyMisdiagnosis:A generalized varicelliform eruptionfor 7 daysnerve,with the features ofhyperaesthesiaThe pain persists

19、after the skintransfer factor(TF)5 3 times dailyTypical lesions:In conclusion:for 7 daysMisdiagnosis:within the distribution of a sensorypain in the affected area.Herpetic inflammation of the geniculate ganglion is felt to be the cause of this syndrome.Postherpetic neuralgia(PHN)Vitamin B:help to re

20、lief the inflammation of the involved nerve and relief the pain.Antivirival therapydermatotropism.Nerve blocksThe eruption may have fewVZV,classically occurs unilaterallyThe regional lymph nodes arePhysical therapywithin the distribution of a sensoryThere are may only neuralgiacrops of clustered ves

21、icles surroundedDefinitionThe pain persists after the skinlesions have healed,with the sameMisdiagnosis:Postherpetic neuralgia(PHN)VZV,classically occurs unilaterallyTopical therapyTopical therapy:5%sclhemorrhagic,necrotic,or bullous.Treatmentby erythema,forming in a discontinuousThe pain persists a

22、fter the skinPathogen and PathogenesisDiagnosis and misdiagnosistransfer factor(TF)quality as that of acute zoster pain.Vitamin B:help to relief the inflammation of the involved nerve and relief the pain.Physical therapyComplicationsand papuloid lesions but withlesions have healed,with the sameThe e

23、ruption may have fewClinical manifestationscommonly in the form of uveitisheadache and feverMisdiagnosis:commonly in the form of uveitistransfer factor(TF)within the distribution of a sensoryseparate in two to four weeks,oftenheadache and feverno blisters.a monthHerpes zoster is caused byThe eruptio

24、n presents as papules and erythema in the dermatome.clustered vesicles.and papuloid lesions but withThe regional lymph nodes areenlarged and tender.Ophthalmic Zosterpain in the affected area.Varicella-Zoster virus(VZV)isAngina pectorisSystemic corticosteroid therapy:VZV,classically occurs unilateral

25、lytransfer factor(TF)Pathogenpain in the affected area.transfer factor(TF)clustered vesicles and neuralgia.enlarged and monly in the form of uveitisafter the primary infection.for 7 daysIn conclusion:quality as that of acute zoster pain.Diagnosis and MisdiagnosisOcular involvement is mostTTFD 25mg t

26、idhyperaesthesiaVZV may5mg im qdClinical manifestationsResults from involvement of the facial and auditory nerves by the VZV.Angina pectorisTopical therapy:5%sclNerve blocksDefinitionOphthalmic ZosterThe eruption may have fewwith scarring.Ophthalmic ZosterlNerve blockslImproving immune function:transfer factor(TF)lSystemic corticosteroid therapy:prednisone 10mg tidlPhysical therapy lTopical therapy:5%scl