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Opojasivayuschy lichen (herpes zoster) - acute viral disease (lesion of spinal ganglia), manifested by pain and skin rashes at the level of damage.

Etiology. Chicken pox virus.

Pathogenesis. Inflammation of one or more spinal ganglia and adjacent areas of posterior roots or homologous formations of cranial nerves. It is assumed that after the chicken pox transferred in childhood, its virus remains in the spinal ganglia. Spontaneously (idiopathic form) or due to severe diseases (leukemia, cancer), suppressing immunity, the virus becomes pathogenic and along with the dermatotropic neurotrophic properties.

Symptoms, course. The disease begins with acute radicular pains, often against a background of general malaise and a small fever. After the pain, bubbles appear in the area of ​​the affected roots; In especially severe cases, they can be bullous or necrotic. In some cases, in addition to segmental rashes, scattered vesicles occur. Occasionally rashes and pains are accompanied by limited paralysis of the muscles; In the case of development of paresis in the muscles of the abdominal wall, protrusions arise, which may give rise to an unreasonable assumption about the presence of a tumor. In half of the cases, the herpes zoster is localized in the thoracic segments, in 20% of cases the triple (gasser) node is affected. In the latter case, pain and eruptions are most often located in zone I of the branch: eyelids, forehead. Herpes zoster ophthalmicus presents a certain danger to vision in case of rash on the cornea; Defeat of the cornea occurs only in cases where the nasociliary branch (skin rashes) is involved. The defeat of the geniculate ganglion leads to eruptions in the auricle, causes the appearance of pain in the face and paresis of the facial, and sometimes cochleovestibular nerve. Occasionally, herpetic rashes appear on the pleura, in the bladder or duodenum. In the acute stage of the disease in the cerebrospinal fluid, lymphocytic pleocytosis is often found. Within a few weeks the skin rashes disappear, the pain stops. However, in middle-aged and especially elderly people, persistent postherpetic neuralgia sometimes occurs. Repeated diseases are extremely rare and are usually observed against a background of severe somatic suffering.

Treatment. Analgesics, antihistamines, tranquilizers, sleeping pills. With the help of disinfectant ointments or solutions (brilliant green), it is necessary to protect the eroded parts of the skin from superinfection. In postherpetic neuralgia, neuroleptics of the phenothiazine series in combination with tricyclic antidepressants (aminazine with amitriptyline or melipramine); This combination with long-term admission pain relief in many patients.

The prognosis is favorable.