zoster(带状疱疹)课件

zoster(带状疱疹)课件

ID:19669556

大小:2.68 MB

页数:40页

时间:2018-10-04

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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

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