PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

PathogenandPathogenesis1Pathogenesis

VZVcausesvaricellainchildhood,andestablisheslatencyinsensorygangliaafterthe

primaryinfection.

VZVmayreplicatelaterinlife,takingadvantageofthedeclineinimmunefunction,travelingdown

thesensorynerveintotheskin,showingneuralgiaandclusteredvesicles.Pathogenesis2ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

Clinicalmanifestations3Featuresoflesions

Theeruptionpresentsaspapulesanderythemainthedermatome.

Overafewdays,crops

of

clustered

redpapulesforminadiscontinuous

band

andquicklyevolveto

clearvesicles

surroundedbyerythema.Featuresoflesions4

Theeruptionmayhavefewlesionsorreachtotalconfluenceinthedermatome.Lesionsmaybecomehemorrhagic,necrotic,orbullous.皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件5

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.

6ComplicationsPostherpeticneuralgia(PHN)

Thepainpersistsaftertheskinlesionshavehealed,withthesamequalityasthatofacutezosterpain.>amonthComplications7OphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

OphthalmicZoster8RamsayHuntsyndrome

ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.VZV.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.RamsayHuntsyndrome9

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件10DisseminatedHerpesZoster

Ageneralizedvaricelliformeruptionaccompanyingthe

segmental

eruption.Ithasbeendefinedasmorethan20lesionsoutsidetheaffecteddermatome.Itoccurschieflyinoldordebilitatedindividuals,especiallyinpatientswithmalignancyandAIDS.DisseminatedHerpesZoster11nerve,withthefeaturesofPostherpeticneuralgia(PHN)PathogenMisdiagnosis:HerpeszosteriscausedbyhyperaesthesiaFeaturesoflesionsdermatotropism.TherearemayonlyneuralgiaHerpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.for7daysFeaturesoflesionsPostherpeticneuralgia(PHN)ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Topicaltherapy:5%sclThepainpersistsaftertheskinestablisheslatencyinsensorygangliaandkeratitis.AnginapectoriscommonlyintheformofuveitisDiagnosisandMisdiagnosisDiagnosisTypicallesions:cropsofclusteredvesiclessurroundedbyerythema,forminginadiscontinuousband,withenlargedregionallymphnodes.Thedistributionofasignaldorsalnerveroot.Obviousneuralgianerve,withthefea12Misdiagnosis:

Painususllyprecedestheeruptionby3or4days,sometimesitmaybemisdiagnosedtootherdiseases,dependingondifferentpart.AppendicitisCholecystitisAnginapectorisMisdiagnosis:13TreatmentBedrestAntivirivaltherapy:acyclovir(ACV)0.25timesdailyvalacyclovir(VCV)1.03timesdailyfamciclovir(FCV)0.53timesdaily

for7daysTreatment14VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.TTFD25mgtidVitB120.5mgimqdAnalgesic:aspirinindomethacin

VitaminB:helptore15NerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%sclNerveblocks16Inconclusion:

DefinitionPathogenClinicalmanifestationsComplicationsDiagnosisandmisdiagnosisTreatmentInconclusion:17Definition

HerpeszosteriscausedbyVZV,classicallyoccursunilaterallywithinthedistributionofasensorynerve,withthefeaturesofclusteredvesiclesandneuralgia.Definition18Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件19ClinicalmanifestationsProdromeTypicallesionsDistributionNeuralgiaClinicalmanifestations20

ComplicationsPostherpeticneuralgia(PHN)OphthalmicZosterDisseminatedHerpesZosterRamsayHuntsyndromeComplicationsPostherpeticneur21DiagnosisandMisdiagnosisTreatment

BedrestAntivirivaltherapyVitaminBAnalgesicNerveblocksDiagnosisandMisdiagnosis22transferfactor(TF)AgeneralizedvaricelliformeruptionVaricella-Zostervirus(VZV)iswithscarring.enlargedandtender.DistributionPostherpeticneuralgia(PHN)Misdiagnosis:PhysicaltherapyThepainpersistsaftertheskinPathogenandPathogenesisPainususllyprecedestheeruptiondermatotropism.qualityasthatofacutezosterpain.enlargedandtender.DiagnosisandMisdiagnosisOphthalmicZostertransferfactor(TF)VZV,classicallyoccursunilaterallycommonlyintheformofuveitis

ImprovingimmunefunctionSystemiccorticosteroidtherapyPhysicaltherapyTopicaltherapytransferfactor(TF)23Thankyou皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件24PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

PathogenandPathogenesis25ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

Clinicalmanifestations26

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.

27OphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

OphthalmicZoster28

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件29PathogenandPathogenesistransferfactor(TF)indomethacinPhysicaltherapyMisdiagnosis:Ageneralizedvaricelliformeruptionfor7daysnerve,withthefeaturesofhyperaesthesiaThepainpersistsaftertheskintransferfactor(TF)53timesdailyTypicallesions:Inconclusion:for7daysMisdiagnosis:withinthedistributionofasensorypainintheaffectedarea.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Postherpeticneuralgia(PHN)VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.Antivirivaltherapydermatotropism.NerveblocksTheeruptionmayhavefewVZV,classicallyoccursunilaterallyTheregionallymphnodesarePhysicaltherapywithinthedistributionofasensoryTherearemayonlyneuralgiacropsofclusteredvesiclessurroundedDefinitionThepainpersistsaftertheskinlesionshavehealed,withthesameMisdiagnosis:Postherpeticneuralgia(PHN)VZV,classicallyoccursunilaterallyTopicaltherapyTopicaltherapy:5%sclhemorrhagic,necrotic,orbullous.Treatmentbyerythema,forminginadiscontinuousThepainpersistsaftertheskinPathogenandPathogenesisDiagnosisandmisdiagnosistransferfactor(TF)qualityasthatofacutezosterpain.VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.PhysicaltherapyComplicationsandpapuloidlesionsbutwithlesionshavehealed,withthesameTheeruptionmayhavefewClinicalmanifestationscommonlyintheformofuveitisheadacheandfeverMisdiagnosis:commonlyintheformofuveitistransferfactor(TF)withinthedistributionofasensoryseparateintwotofourweeks,oftenheadacheandfevernoblisters.>amonthHerpeszosteriscausedbyTheeruptionpresentsaspapulesanderythemainthedermatome.clusteredvesicles.andpapuloidlesionsbutwithTheregionallymphnodesareenlargedandtender.OphthalmicZosterpainintheaffectedarea.Varicella-Zostervirus(VZV)isAnginapectorisSystemiccorticosteroidtherapy:VZV,classicallyoccursunilaterallytransferfactor(TF)Pathogenpainintheaffectedarea.transferfactor(TF)monlyintheformofuveitisaftertheprimaryinfection.for7daysInconclusion:qualityasthatofacutezosterpain.DiagnosisandMisdiagnosisOcularinvolvementismostTTFD25mgtidhyperaesthesiaVZVmay5mgimqdClinicalmanifestationsResultsfrominvolvementofthefacialandauditorynervesbytheVZV.AnginapectorisTopicaltherapy:5%sclNerveblocksDefinitionOphthalmicZosterTheeruptionmayhavefewwithscarring.OphthalmicZosterNerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%sclPathogenandPathogenesisPosth30PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

PathogenandPathogenesis31Pathogenesis

VZVcausesvaricellainchildhood,andestablisheslatencyinsensorygangliaafterthe

primaryinfection.

VZVmayreplicatelaterinlife,takingadvantageofthedeclineinimmunefunction,travelingdown

thesensorynerveintotheskin,showingneuralgiaandclusteredvesicles.Pathogenesis32ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

Clinicalmanifestations33Featuresoflesions

Theeruptionpresentsaspapulesanderythemainthedermatome.

Overafewdays,crops

of

clustered

redpapulesforminadiscontinuous

band

andquicklyevolveto

clearvesicles

surroundedbyerythema.Featuresoflesions34

Theeruptionmayhavefewlesionsorreachtotalconfluenceinthedermatome.Lesionsmaybecomehemorrhagic,necrotic,orbullous.皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件35

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.

36ComplicationsPostherpeticneuralgia(PHN)

Thepainpersistsaftertheskinlesionshavehealed,withthesamequalityasthatofacutezosterpain.>amonthComplications37OphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

OphthalmicZoster38RamsayHuntsyndrome

ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.VZV.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.RamsayHuntsyndrome39

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件40DisseminatedHerpesZoster

Ageneralizedvaricelliformeruptionaccompanyingthe

segmental

eruption.Ithasbeendefinedasmorethan20lesionsoutsidetheaffecteddermatome.Itoccurschieflyinoldordebilitatedindividuals,especiallyinpatientswithmalignancyandAIDS.DisseminatedHerpesZoster41nerve,withthefeaturesofPostherpeticneuralgia(PHN)PathogenMisdiagnosis:HerpeszosteriscausedbyhyperaesthesiaFeaturesoflesionsdermatotropism.TherearemayonlyneuralgiaHerpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.for7daysFeaturesoflesionsPostherpeticneuralgia(PHN)ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Topicaltherapy:5%sclThepainpersistsaftertheskinestablisheslatencyinsensorygangliaandkeratitis.AnginapectoriscommonlyintheformofuveitisDiagnosisandMisdiagnosisDiagnosisTypicallesions:cropsofclusteredvesiclessurroundedbyerythema,forminginadiscontinuousband,withenlargedregionallymphnodes.Thedistributionofasignaldorsalnerveroot.Obviousneuralgianerve,withthefea42Misdiagnosis:

Painususllyprecedestheeruptionby3or4days,sometimesitmaybemisdiagnosedtootherdiseases,dependingondifferentpart.AppendicitisCholecystitisAnginapectorisMisdiagnosis:43TreatmentBedrestAntivirivaltherapy:acyclovir(ACV)0.25timesdailyvalacyclovir(VCV)1.03timesdailyfamciclovir(FCV)0.53timesdaily

for7daysTreatment44VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.TTFD25mgtidVitB120.5mgimqdAnalgesic:aspirinindomethacin

VitaminB:helptore45NerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%sclNerveblocks46Inconclusion:

DefinitionPathogenClinicalmanifestationsComplicationsDiagnosisandmisdiagnosisTreatmentInconclusion:47Definition

HerpeszosteriscausedbyVZV,classicallyoccursunilaterallywithinthedistributionofasensorynerve,withthefeaturesofclusteredvesiclesandneuralgia.Definition48Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件49ClinicalmanifestationsProdromeTypicallesionsDistributionNeuralgiaClinicalmanifestations50

ComplicationsPostherpeticneuralgia(PHN)OphthalmicZosterDisseminatedHerpesZosterRamsayHuntsyndromeComplicationsPostherpeticneur51DiagnosisandMisdiagnosisTreatment

BedrestAntivirivaltherapyVitaminBAnalgesicNerveblocksDiagnosisandMisdiagnosis52transferfactor(TF)AgeneralizedvaricelliformeruptionVaricella-Zostervirus(VZV)iswithscarring.enlargedandtender.DistributionPostherpeticneuralgia(PHN)Misdiagnosis:PhysicaltherapyThepainpersistsaftertheskinPathogenandPathogenesisPainususllyprecedestheeruptiondermatotropism.qualityasthatofacutezosterpain.enlargedandtender.DiagnosisandMisdiagnosisOphthalmicZostertransferfactor(TF)VZV,classicallyoccursunilaterallycommonlyintheformofuveitis

ImprovingimmunefunctionSystemiccorticosteroidtherapyPhysicaltherapyTopicaltherapytransferfactor(TF)53Thankyou皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件54PathogenandPathogenesis

Pathogen

Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.

PathogenandPathogenesis55ClinicalmanifestationsProdrome:

headacheandfeverhyperaesthesiapainintheaffectedarea.

Clinicalmanifestations56

Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.

57OphthalmicZoster

Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.

OphthalmicZoster58

Incompleteherpeszoster

Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.

皮膚性病學(xué)英文帶狀皰疹英文教學(xué)培訓(xùn)課程課件59PathogenandPathogenesistransferfactor(TF)indomethacinPhysicaltherapyMisdiagnosis:Ageneralizedvaricelliformeruptionfor7daysnerve,withthefeaturesofhyperaesthesiaThepainpersistsaftertheskintransferfactor(TF)53timesdailyTypicallesions:Inconclusion:for7daysMisdiagnosis:withinthedistributionofasensorypainintheaffectedarea.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Postherpeticneuralgia(PHN)VitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.Antivirivaltherapydermatotropism.NerveblocksTheeruptionmayhavefewVZV,classicallyoccursunilaterallyTheregionallymphnodesarePhysicaltherapywithinthedistributionofasensoryTherearemayonlyneuralgiacropsofclusteredvesiclessurroundedDefinitionThepainpersistsaftertheskinlesionshavehealed,withthesameMisdiagnosis:Postherpeticneuralgia(PHN)VZV,classicallyoccursunilaterallyTopicaltherapyTopicaltherapy:5%sc