Viral herpes

Viral herpes (HerpesSimplex) is a viral skin disease caused by viral herpes virus. Divided into herpes simplex and herpes zoster, herpes simplex (herpessimplex) is a herpes simplex virus-induced skin disease, good invasion of the skin and mucous membranes at the junction, manifested as a limited cluster of small blisters, herpes zoster (herpeszoster) is caused by herpes viruses, the distribution of dense small blisters and neuralgia along the side of the peripheral nerves in a band-like manner, and localized lymphadenopathy The herpeszoster is an acute viral skin disease mainly characterized by herpes virus.

Aetiology

The disease is caused by HerpesSimplexVirus (HSV), a DNA virus. Human viral herpes is divided into two types, viral herpes type I (HSV-I) and viral herpes type II (HSV-II). Type I causes infections of the skin, mucous membranes (oral mucosa) and organs (brain) other than the genitals. Type II causes infections of the skin and mucous membranes of the genital area. These two types can be determined by fluorescence immunoassay and cell culture.

Human beings are the only natural hosts of viral herpes. Virus through the respiratory tract, oral cavity, genital mucosa and broken skin into the body, latent in the human body recreational mucosa, blood, saliva and learned that the ganglion cells. Primary infection is mostly recessive, mostly without clinical symptoms or subclinical apparent, only individuals can surface clinical symptoms. After the primary infection occurs, the virus can be hidden in the body for a long time. About 50% of the healthy population are carriers of this virus. HSV does not produce long-lasting immunity in the body, whenever the body proportional to the value of the decline, such as fever, gastrointestinal disorders, menstruation, pregnancy, focal infection and motivation to change sides, the body of the hidden HSV is activated and the onset of the disease.

Studies have proved that patients with recurrent viral herpes can have cellular immunodeficiency. It is commonly believed that HSV-II is associated with cervical carcinogenesis.

Pathogenesis

Herpes simplex is caused by herpes simplex virus (divided into type I and type II), and the human body is its only natural host. When the body's resistance decreases, it promotes the development of this disease, which pathologically manifests itself in the form of intra-epidermal blisters, epidermal necrolysis, multinucleated epithelial giant cells, eosinophilic intranuclear inclusions, and a significant inflammatory infiltrate of neutrophilic leukocytes and lymphocytes. Herpes zoster is due to the activation of the latent varicella-zoster virus in the body, this virus since the first infection of the patient, long-term latent in the body's neuronal cells, the immune function is low when induced by the histopathology of the former is similar to the former, but the latter inflammation is heavier than the former.

Clinical manifestations

Herpes simplex is clinically divided into two types: primary and recurrent. The primary type manifests itself in herpetic gingivostomatitis, herpetic vulvovaginitis, inoculative herpes simplex, herpetic eczema, disseminated herpes simplex, neonatal herpes, etc.,?

Viral herpes

Recurrent types include herpes orofacialis (facial herpes), genital herpes, herpesvirus type II infection, and recurrent herpetic keratoconjunctivitis. Herpes zoster starts suddenly or first pain, damage to the inflammatory erythema on the occurrence of clusters of mung bean-sized blisters, between the appearance of papules, blisters or blood blisters, between the groups of normal skin, the rash is often along the peripheral nerves for the band distribution, unilateral sex is common to intercostal nerves and the trigeminal nerve area is common, and its intersection is the brachial plexus nerve of the upper limbs and lower limbs of the sciatic nerve area, occasionally affect the eye, causing keratitis, iritis, total ophthalmoplegia, etc..

The disease lasts 2 to 3 months or longer, and the local lymph nodes are often enlarged, with pressure and pain, and the severe cases may have fever and varying degrees of pain.

HSV can quickly produce immunity after the lesions are confined to the surface of the skin and mucous membranes, and immune function is not yet mature newborns and immune deficiency (such as organ transplantation, immunosuppressive drugs and antitumor treatment of the patient) HSV infection, the lesions are often spread to the whole body, such as the brain, liver, lungs, eyes, adrenal glands, and the skin and mucous membranes, and so on, heavy disease, high mortality rate. In the case of extensive skin injuries such as eczema and burns, HSV infection often manifests as generalized herpes of the skin and mucous membranes, and can cause systemic dissemination of lesions, with severe conditions. In pregnant women with genital herpes, HSV is transmitted to the fetus through the cervix by upstream infection, resulting in congenital infection and causing stillbirth, miscarriage, preterm delivery and congenital malformations, and the virus can also pass through the birth canal and cause neonatal infections in labor and delivery.The incubation period of HSV infection is from 2 to 12 days, with an average of 6 days, and there can be different clinical manifestations in different clinical types.

Diagnosis

Based on clustered blisters at the junction of the skin and mucous membranes, with mild self-consciousness and a burning sensation on one side of the lesion. The diagnosis is made by the short duration of the disease, repeated reoccurrences, and occurrence during fever or gastrointestinal efficacy disorders.

Therapeutic principles

Herpes simplex systemic treatment when taken symptomatic, antiviral and immunotherapy, local treatment to dry, astringent, prevention of infection as the principle, avoid using corticosteroid ointment, because it can inhibit serum interferon.

Herpes zoster should also be used systemic and local therapy, the principle of antimicrobial viruses, anti-inflammatory, analgesic, protection of the local area, to prevent secondary infections, shorten the duration of the disease.

Commonly used drugs

Herpes simplex

Local medication

Antiviral agents: 40% herpes net dimethyl sulfoxide solution, acyclovir, phthalidomide, herpes Lixiang.

Antibacterial antipruritic agent: camphor, gentian violet, glycerite lotion, etc.. Anti-infection drugs antibiotics

Internal

Antiviral agents: acyclovir, adenosine, interferon, interferon inducer, etc.

Immunologic agents: levamisole, transfer factor, etc.

Herpes zoster

Herpes zoster

Systemic medications

Pain relievers: craniosynephrine, anandamide, carbamazepine, amitriptyline, doxepin, promethazine, amidamidazole, phenyltoxin sodium, cyproheptadine, tylenol, and others.

Antiviral agents: morpholino guanidine, cytarabine, acyclic guanosine, etc.

Immunologic agents: transfer factor, placenta globulin, propecia immune serum and so on.

Topical

Pain relievers: 1% dacronine, 5% benzocaine, 1% phosphoacetic acid, herpolis, etc.