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1、HerpesZosterDepartmentof DermatologyandVenereologyDuMaotao2014-11-28PapuleReviewPlaqueDoyouknowthefollowingskinlesions?ReviewBullaDoyouknowthefollowingskinlesions?VesicleSkinlesionsjustlikeletters. Withoutthem, we willnotbeableto read theliterature ofskin.——Dr.DarierHowtodescribethislesion
2、?HerpesZosterDefinitionHerpeszosteriscausedbyVaricella-Zostervirus(VZV),classicallyoccursunilaterallywithinthedistributionofasensorynerve,beingcharacterizedbyclusteredvesiclesandconsiderableneuralgia.PathogenandPathogenesisPathogenVaricella-Zostervirus(VZV)ischaracterizedbyneurotropismandd
3、ermatotropism.Itsoonloseactivityinthedryenvironment.ElectronmicrographofVaricellazostervirusPathogenesisVZVcausesvaricellainchildhood,andestablisheslatencyinsensorygangliaaftertheprimaryinfection.VZVmayreplicatelaterinlife,takingadvantageofthedeclineinimmunefunction,travelingdownthesensory
4、nerveintotheskin.PathogenesisskinskinnerveganglionTheincidenceofherpeszosterincreaseswithadvancingageanddeclineinimmunefunction.ClinicalmanifestationsProdrome:headacheandfeverhyperaesthesiapainFeaturesoflesionsTheeruptioninitiallypresentsaspapulesandplaquesoferythemainthedermatome.Overafew
5、days,cropsofclusteredredpapulesforminadiscontinuousbandandquicklyevolvetoclearvesicles.TypicalfeaturesoflesionsLesionsmaybecomehemorrhagic,necrotic,orbullous.Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparatein2to4weeks,oftenwithscales.Thetotaldurationoftheeruptiondepend
6、sonthreefactors:patientage;severityoferuption;presenceofunderlyingimmunosuppression.Distributioncranialorspinalsensorynerve.thethoracic(55%)thecranial(20%),withthetrigeminalnervebeingthemostcommonsinglenerveinvolved.thelumbar(15%)thesacral(5%)NeuralgiaThenatureofpainassociatedwithherpeszos
7、tervaries,butthreebasictypesofpainhavebeendescribed.theconstant,monotonous,usuallyburningordeep,achingpain;theshooting,lancinatingpain;thetriggeredpain.HyperaesthesiaTheskinintheaffectedareamaybehypersensitive,normallyInnocuousstimulation,suchasclothingtouchin
