Shingles is known to us as an extremely unpleasant disease that disrupts the usual way of life due to itching and pain. Almost no one is immune from the manifestation of its symptoms, since the causative agent is a virus that spreads extremely quickly among people. However, at the present stage of development of medicine, a person not only collected a lot of information about what shingles is, but also developed methods for successful treatment.
The disease itself has been known for a long time, the first mention of its symptoms was found in antiquity, however, due to the lack of technological capabilities to carry out differential diagnostics, herpes zoster and chickenpox belonged to different ailments: lichen was considered a separate skin disease, while chickenpox could be mixed with other types of smallpox. Later discoveries in the field of medicine helped to describe both diseases.more specifically and identified a common pathogen.
General information about the disease
Shingles (according to ICD-10 code B02 is assigned to it) can also be called herpes zoster, as it is provoked by the herpes zoster virus - the same one that causes chicken pox. Therefore, those who have already had contact with viruses and have had chickenpox are susceptible to the disease. However, in some cases, the virus can immediately manifest itself in the form of shingles. It is extremely rare and usually occurs among immunocompromised people.
In general, older people are at particular risk for developing symptoms of shingles in adults. Among children, it is usually those whose immune system is weakened that get sick. The risk of getting shingles in a child with HIV-positive status is also extremely high. The period, which is the most dangerous, is autumn-winter. At the same time, many people's immunity is seriously weakened, so the symptoms of shingles in adults and the treatment of this disease should be under special control in the fall and winter. Particular attention should be paid to the elderly and those who have recently undergone severe treatment. The age at which it is necessary to closely monitor possible human contact with carriers of chickenpox is from sixty years old.
Shingles in a child can occur at almost any time of the year, but in autumn and winter, the he alth of the baby should be monitored more closely, especially if he is prone to frequent colds.
Frequencyappearances
The incidence of the disease is up to fifteen people per one hundred thousand people in the age range from sixty years. Those whose immunity is significantly weakened can suffer the disease again. In this case, the patient already knows well what shingles is, and independently limits his contacts with those who have had chickenpox. However, the contact of a child who has not suffered from chickenpox with a person suffering from this type of lichen does not carry particular dangers, as it is manifested by the symptoms of chickenpox.
The process of spreading the virus
What is shingles? The virus itself is extremely contagious. It spreads both by direct contact with vesicles on the epidermis, and by airborne droplets. This means that it is possible, even without contact with rashes, to become infected with an unpleasant disease.
In some cases, transmission of the virus through the placenta can occur. Tests of infected babies are subsequently tested for virus activity, after which the babies are treated.
When there is a danger of becoming infected, you need to carefully protect yourself from contact with possible carriers, but remember that most of the pathogenic particles that enter the body are successfully inactivated by the immune system. Therefore, it is possible to limit the spread of the virus by improving the overall he alth of people, including promoting the strengthening of immunity.
Reasons for appearance
The causative agent of shingles is the herpes zoster virus. The same virus causes the symptoms of common chickenpox: blisters on the skin thatcontain liquid inside and are prone to itching. As a rule, after the disease passes, a person retains specific immunity to the herpes zoster virus, and he is no longer threatened with chicken pox. However, the herpes particle itself remains in the body in a suppressed form for life. And therefore, as soon as the immune system begins to act a little less intensively on the virus, the particle wakes up and begins activity. In this case, the symptoms of shingles in adults (the photo attached below shows the initial stages of the disease) will not keep you waiting.
However, not all people with impaired immunity will suffer specifically from this disease.
In addition to problems with immunity, the following factors can influence the awakening of the virus:
- Treatment with drugs that have immunosuppressive (suppressive immunity) effects.
- The impact of severe stress on the body, as well as overwork and excessive mental stress.
- Oncological diseases and the treatment of these ailments (chemo- and radiation therapy).
- HIV infection in the absence of drugs that inhibit the virus.
With viral immunodeficiency, the manifestations of shingles in adults (pictured) are practically not amenable to treatment and occur extremely quickly. Therefore, we can say that with serious disorders of the immune system, herpes viruses are among the very first to show themselves in the body.
Symptomatics
A photo of the symptoms of shingles in a person can be easily found,however, like most skin diseases, the usual image of the rash does not give a complete picture of what the disease looks like in a particular patient. For a more successful diagnosis, a detailed description of each feature of the disease is necessary:
- The very initial stage is characterized by a condition resembling colds and flu: weakness, lethargy, in rare cases, fever. There is also a headache and a slight ache in the bones. The first stage of the disease can be mistaken for a cold and no action is taken. However, already after the appearance of this symptom in a person, shingles manifests itself in the form of rashes.
- After 1-2 days after the appearance of lethargy, rashes in the form of bubbles appear on the body. All vesicles are filled with liquid containing millions of copies of the virus. It is extremely undesirable to destroy the bubbles on your own, since you can additionally seed them with bacteria, which can cause rapid suppuration on damaged skin. Many people may be wondering how shingles does. In fact, girdling, as such, does not occur. Bubbles are located either on one side of the body, or along the nerves, or in the intercostal part of the chest. Rashes are localized on one part of the body and, as a rule, do not appear in other places. In the latter case, shingles encircles as if diverging along the thoracic part of the body lines. In almost all cases, the blisters are painful and itchy. The strength of pain and itching in this case depends on the individual patient, and some admit that they cannot fullydo your normal activities.
- After a week, the bubbles begin to dry out. At first they retract, becoming covered with a crust, but later they form scars that look like plaques above the skin from the side. Many of the plaques are lighter in color than the surrounding skin. As a rule, complete relief of the symptoms of shingles in a person with treatment and normal immunity takes from 2 weeks to a month. However, if the patient has a pronounced immunity deficiency, then the treatment may be delayed for a long time, and the disease itself will be much more difficult.
- However, even if the main symptoms of the disease have already disappeared, problems with pain can persist up to several years. This is called postherpetic neuralgia and, unlike shingles itself in adults, does not require treatment. But you can use symptomatic therapy in the form of ointments containing substances from the NSAID group: Ketoprofen, Diclofenac, Nimesulide and others.
There are also so-called atypical forms of herpes zoster. Atypical is called a variation in the development of the disease, when its clinical picture differs significantly from that which is observed most often. In the case of shingles, these are the following forms of the disease:
- A form in which rashes and pain are completely absent, however, viral particles are present in the body in an activated state in large quantities.
- The bullous form is characterized by large blisters with jagged edges.
- Bubblesfilled with content in which bloody inclusions are visible. As a rule, such bubbles tend to leave scars behind and heal for a long time.
- Necrotic form, in which vesicles can contribute to the formation of necrosis of adjacent tissues. It is especially dangerous because healing is extremely slow, and patients at risk of this form of the disease are mainly elderly people with a history of diabetes.
- Generalized. As the name implies, this form of the disease manifests itself in the fact that rashes do not appear on one part of the body. Vesicles in the generalized form of herpes zoster cover the entire body of the patient and are visible on both sides of the body.
- Especially rare, but the most dangerous form - encephalitic. It is manifested by rashes in the region of the cervical spine, and the virus can affect the nerves leading to the spinal cord. In especially severe cases, after some time, symptoms of encephalitis begin, which can lead to coma. This is the only form of shingles that can actually threaten the patient's life: about 60% of patients with it die. In this case, the principle of timely diagnosis of the disease and the earliest possible start of its treatment is more important than ever.
The symptoms of shingles in the photo can be extremely depressing, which in itself is not conducive to a speedy recovery. Therefore, when the first signs of the disease appear, it is necessary to give the patient information that at the current level of development of medicine it is successful.treated in a few weeks if the patient does not have severe immunodeficiencies.
Complications after illness
Despite all the treatment of herpes zoster, in adults, the symptoms (photo below) may not go away for quite a long time, and in especially severe cases, complications may occur, including those that significantly undermine the patient's he alth. These complications affect mainly the nervous tissue, which makes their consequences much more dangerous. But since the virus in the active stage causes damage to the entire body, all organs and organ systems can suffer from it. In particular, when herpes affects the motor branches of the nerves, the symptoms of herpes zoster in a person (pictured) may not be stopped by treatment, and the pain may persist for up to a year. In particularly difficult situations, the patient may begin to suffer from paralysis.
Also, if the facial nerves are affected, the patient's face may become distorted. Some parts of it, for example, ears or eyes, may also suffer. In the case of the ear form, the probability of violations of the facial nerves increases significantly. The eyes, on the other hand, can be especially severely affected as a result of the disease, a person may even partially lose sight.
Also, if bacteria are present in the body, suppuration may form at the site of the formation of blisters, which will significantly slow down their drying and, as a result, delay the final healing for a few more weeks.
In order for the symptoms of herpes zoster (the photo in the article shows the initial stages of the rash) to disappear faster after treatment, it is necessarystart therapy as early as possible. Ideally, the start of medication should coincide with the symptoms of a cold. However, there are a sufficient number of treatment features that depend not only on the level of immunity, but also on the age of the patient.
In some cases, shingles can cause other diseases:
- Ramsey-Hunt Syndrome. This disease affects the peripheral facial muscles, and also manifests itself as profuse rashes in the ear canal.
- Motor and ophthalmic herpes zoster affecting the nerves associated with muscle tissue and the eye.
Both the listed diseases, as well as individual milder complications, can cause serious harm to he alth. Therefore, it is necessary to protect yourself as much as possible from the possible development of complications, first of all, by observing the hospital regime.
Treatment for shingles (adult photo attached)
Priority areas of therapy cover several aspects of the disease:
- Speed up the healing of already existing rashes.
- Perform pain relief therapy to improve the patient's quality of life during the illness.
- Reduce the likelihood of complications and the development of a severe form of the disease.
- Reduce the chance of pain persisting after recovery as postherpetic neuralgia is extremely difficult to manage.
Before embarking on the therapy itself, it is necessary to deal with the stress that may appear after identifying the signs of the disease. Shingles rash inadults and children can cause excessive fright, affecting the psychological state of the patient, especially in old age. The first thing to do in this case is to reassure the person that modern medicine can treat this disease well enough and there is nothing to worry about. In some cases, light sedatives may be indicated to help prepare psychologically for therapy. Then you can start treatment. In adults, shingles is not so difficult to cure.
Of course, the first necessity is to see a doctor. It is the specialist who must carry out all the procedures and establish the final diagnosis. Usually, the diagnosis does not take much time, and the doctor can almost immediately determine the presence of the disease in the patient. After that, the treatment itself begins, requiring the use of not so much specialized antiviral drugs for shingles as maintenance therapy in the form of vitamins and painkillers to relieve severe pain. It is necessary to distinguish between antiviral drugs and antibiotics: the former are the drugs of choice for viral skin diseases, and the latter are required only if bacterial contamination and the risk of suppuration appear on the ground.
Remember that the virus is successfully carried by the wind, and the discharge from the blisters on the skin contains many copies of the virus particles. Therefore, it is highly desirable to observe a hospital regimen during treatment and not to visit crowds of people unless absolutely necessary. This will help not only savesurrounding from infection, but also contribute to the stabilization of the patient's immune system. It is necessary to explain to the patient that, in addition to the aesthetic factor, there is also a risk of transmitting the virus to other people.
Pain medications are symptomatic therapy that helps the patient return to normal life. It is competent anesthesia that helps to get rid of pain at the site of the rash, which can interfere not only with comfort, but also with breathing or movement. As painkillers, drugs from the NSAID group are used: Diclofenac, Ketoprofen and others. However, in some countries, such as the United States, the use of narcotic analgesics is allowed for the relief of very severe pain, as well as in the treatment of patients with severe herpes zoster.
The main medication used to treat herpes zoster is antiviral drugs. The drugs of choice, in this case - "Acyclovir", "Valacyclovir", "Famciclovir" and their analogues from the same drug group. Their action is based on the incorporation of a drug molecule into the DNA of a viral particle and a complete stop of its reproduction. All drugs from this group act similarly, the differences between them lies in the rate of suppression of viral particles. At the moment, antiviral drugs are the most well-known and effective medicines in the fight against diseases caused by the herpes virus.
There arealso medications that are not used at this stage for one reason or another. First of all, these are corticosteroids. Despite their activity against inflammation and itching, corticosteroids may not be safe. First of all, they significantly reduce the immune system (immunosuppressive effect), which further interferes with the successful suppression of the virus by the body itself. Their use in the treatment of herpes zoster is currently not recommended.
However, in most patients, the disease resolves without medical treatment in a few weeks. It is recommended to use antiviral therapy only in patients with comorbidities and the elderly. Treatment is carried out on an outpatient basis. Inpatient therapy is practiced only in case of severe forms of the disease.
Shingles in children
As a rule, young children do not suffer from this disease, since when they become infected with herpes zoster, they develop symptoms of chicken pox. However, in some cases, the child may also suffer from shingles.
Symptoms and treatment of shingles in adults can be called much easier than the symptoms and treatment of the disease in a child, especially if this baby is very small. Most often, this type of disease is found in children with HIV or other ailments characterized by significant immunodeficiency. In this case, the timely prescription and administration of antiretroviral drugs usually helps to eliminate symptoms, since immunityreturns to normal.
In humans, shingles can occur only if the virus itself is already present in the body. This means that earlier the child had already had chicken pox, and there was a re-infection with reduced immunity. The second factor that can cause this disease in a young organism is the presence of immunodeficiencies that contribute to the activation of viral particles, which should normally be suppressed by the immune system.
In children, the symptoms are characterized by a greater blurring of manifestations than in adult patients, so the doctor's control is needed even more than in the case of a disease in an adult.
As a rule, the child is treated on an outpatient basis, that is, without hospitalization. However, in the case of a severe course of the disease, hospital conditions may be required. This is especially important for children diagnosed with immunodeficiency. Any viral disease in this case can threaten with serious consequences, and therefore such children are observed only permanently.
Treatment is carried out according to a scheme similar to the treatment scheme for an adult, only the dosages of the drugs used change. And yet, in children, it is undesirable to use painkillers from the NSAID group, as they have negative side effects that can cause serious disruption of the gastrointestinal tract in a child. Treatment of a child must be prescribed and supervised by a pediatrician.
Diagnosis
All diagnostic procedures, as well as treatment, for shingles are handled by a doctor-infectiologist. As a rule, the diagnosis of the disease is quite simple, since the symptoms are pronounced on the patient's skin in the form of rashes. However, in some cases laboratory diagnostics may be required. It is carried out mainly in infants or children with immunodeficiencies. If the herpes infection is in an atypical form, then laboratory tests may be urgently needed.
Basically, when diagnosing in the laboratory, methods for detecting antibodies to the herpes zoster virus are used. In the case of the appearance of bubbles on the skin, the PCR method is used, with which a sample of secretions taken from the bubble can be analyzed. But the PCR technique is used much less frequently, while the detection of antibodies in the body is used, including when a child is suspected of being infected with a virus in the womb. PCR is most used in the presence of a disease that gives rashes on internal organs and does not give external manifestations.
During the diagnosis, shingles must be differentiated, that is, separated from other possible skin diseases, including those of a viral nature: herpes simplex, eczema and chicken pox. However, most doctors know what shingles is, and the diagnosis is usually straightforward.
Preventive measures and prognosis after illness
Currently, pharmaceutical companies are developing several vaccines designed to protect people from infection with the herpes zoster virus. However, they are used quite rarely, since the vaccine is live (thenif it contains weakened but live viral particles of another virus similar in structure to herpes zoster) and may adversely affect the he alth of immunocompromised patients. Also, some antiviral drugs taken by a person during treatment for other diseases can weaken the effect of the vaccine or completely inactivate it.
The main measure for the prevention of shingles now is to protect the patient at risk of infection from potentially ill people as much as possible. It is best to keep immunocompromised children away from children with chickenpox to avoid infection.
It is also of utmost importance to follow the doctor's recommendations during the treatment of diseases that can lead to immunodeficiency. If a patient is diagnosed with HIV, he needs to take drugs that suppress the virus on time and maintain consistency in the implementation of the treatment regimen. At the moment, it is patients with HIV who make up a fairly significant proportion of all cases of herpes zoster.
You should also try to reduce the influence of all factors that can lower immunity, including stress loads. You need to eat right and have regular exercise. This helps to keep your body in good shape and helps to strengthen the immune system, which in turn helps keep most of the opportunistic viruses in the body suppressed.
If all of the above tips have been followed, then the likelihood of getting shingles is reduced to a minimum. However,understand that regular medical examinations help to detect the disease at an early stage, even if the virus has manifested itself despite efforts. Early treatment contributes to a faster recovery and minimizes the possible consequences of the disease for the patient.
But even if the symptoms of the disease have manifested themselves, do not worry: uncomplicated shingles, as a rule, resolves in a few weeks and the reappearance of the disease is extremely unlikely unless the patient suffers from severe immunodeficiency conditions.
Illness is nothing to fear for a person without comorbidities. However, in some cases, it can cause serious harm, and therefore, if dangerous signs appear on the body, it is necessary to immediately diagnose the general condition of the body and urgently begin treatment in case of identified problems.
For HIV patients, shingles poses a certain danger, but if you go to the hospital in a timely manner and strictly follow the doctor's recommendations, a full recovery is possible.
