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11.08.2015

Herpes shingles treatment, naturopathy - Review

Author: admin
Herpes zoster infection (shingles) results from the reactivation of varicella zoster virus infection. While varicella virus infection mostly affects the young, shingles and its complications mainly affect older persons.
The initial stage of shingles precedes the active stage with a conundrum of symptoms that last several days or weeks before the shingle rash appears. The main symptom associated with postherpetic neuralgia is pain, which persists for a long period beyond the resolution of the shingles rash. Significant scarring may result from cutaneous herpes zoster and this is most problematic with facial involvement.
In most circumstances, the diagnosis of cutaneous herpes zoster is made on clinical grounds.
The following treatment recommended for varicella and zoster are based on the 2009 document Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adolescents and Adults[4].
In excess of 60% of people older than 60 years, especially those with diminished immunity due to diabetes and cancers, are afflicted by herpes zoster.
Patients with early signs of shingles complain of headaches, hypersensitivity to light, flulike symptoms without fever, itching, tingling, and burning or pain around the affected area.
Prednisone use in conjunction with acyclovir resulted in the reduction of the pain associated with acute herpes zoster. The outcome of treatment of shingles is often unsatisfactory, although the antiviral medications reduce the duration of pain during the acute phase but do not prevent PHN complications and pain. More than 50% of the people who live to be 85 years old will develop shingles, and 80% to 85% of PHN complication occurs in patients older than 50 years. Given the widespread prevalence of varicella-zoster virus (VZV) infection in adults, most HIV-infected adults are at risk of developing VZV reactivation and herpes zoster.
Reactivation of herpes zoster in the trigeminal ganglia may lead to the development of herpes zoster ophthalmicus, a condition that includes a number of inflammatory manifestations in the eye, such as conjunctivitis, episcleritis, keratitis, and iritis.
All patients with an acute episode of varicella or zoster should promptly receive antiviral treatment[4].


In contrast, HIV-infected persons with complicated primary varicella infection, including involvement of visceral organs, retina, or the central nervous system, should receive treatment with intravenous acyclovir and undergo hospitalization for observation (Figure 7). The recommended antiviral treatment options (Figure 8) for localized dermatomal zoster in HIV-infected persons consist of valacyclovir (Valtrex), famciclovir (Famvir), or acyclovir (Zovirax)[4]. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.
Thus, early management of shingles is essential to prevent the many complications, especially the chronic, debilitating, difficult-to-treat PHN pain that often results from the condition.
Patients with herpes zoster often present with dysesthesias of the skin several days prior to the onset of cutaneous lesions. Post-herpetic neuralgia (defined as pain that persists longer than 30 days after the onset of the rash) is a significant problem associated with herpes zoster infection, but, after adjusting for age, the risk of post-herpetic neuralgia does not differ significantly among HIV-infected persons compared with immunocompetent persons[7]. The direct fluorescent antibody (FA) assessment of a cellular rich sample from the base of the lesion offers the most sensitive, specific, and rapid diagnosis for herpes zoster. Note these antiviral medications are administered at doses higher than those commonly used for the treatment of uncomplicated herpes simplex virus infections. One report described 18 HIV-infected patients with advanced immunosuppression and acyclovir-resistant VZV-related skin lesions that failed to heal despite treatment with acyclovir[15]; most of these patients had an excellent respond to treatment with foscarnet (Foscavir).
Low levels of immune globulin have been shown to predispose patients to recurring herpes zoster infection. Despite the usefulness of prednisone in managing the associated pain with herpes zoster infection, it has not been shown to decrease or prevent the incidence of PHN.
I believe it is a neurologic condition and that it should be aggressively treated with some kind of physiologic treatments by a neurologist.
The diagnosis of herpes zoster should prompt the clinician to consider HIV testing, particularly in persons with known HIV risk factors, those younger than 50 years of age, or those who develop multi-dermatomal herpes zoster. In these cases of complicated varicella, if the patient responds well to intravenous acyclovir, they can typically switch to oral antiviral therapy to finish their treatment course[4]. Postherpetic neuralgia is very resistant to treatment and results in decreased quality of life.


Pain is the primary complaint with active-stage shingles and the symptom for which patients seek medical care. Although herpes zoster can occur anywhere on the body, the skin of the thorax is the most frequently involved region. Bacterial superinfection of vesicles can also complicate cutaneous herpes zoster (Figure 6). The pain is stipulated to be due to persistent C-fiber nociceptor activity in the nerve cells, although studies have shown chronic neural loss and scarring in nerves affected by herpes zoster injury. Lidocaine patches were superior to both no treatment and vehicle patches in averaged category pain relief scores.
Combining TCAs with antiviral drugs during herpes zoster infection has been shown to decrease the intensity of PHN pain but does not prevent it. Accordingly, the use of corticosteroids as part of the treatment for herpes zoster in HIV-infected persons is not recommended[4].
Although other infections, such as herpes simplex virus and smallpox, may cause similar appearing vesicular lesions, the characteristic dermatomal distribution of herpes zoster helps to distinguish herpes zoster from these other disorders.
Cutaneous dissemination generally occurs only among immunocompromised patients, occurring in up to 37% of zoster cases in the absence of antiviral treatment.
Valacyclovir appears to be more efficacious in decreasing the severity of pain associated with acute herpes zoster and the duration of the PHN when compared to acyclovir. When antiviral therapy starts within 72 hours of the onset of herpes zoster, acyclovir, valacyclovir, and famciclovir have been shown to significantly shorten the periods of acute pain, virus shedding, rash, and acute and late-onset complications.
Other rare neurologic complications of herpes zoster include myelitis, aseptic meningitis, and meningoencephalitis.



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Comments to “Herpes shingles treatment”

  1. Rashadik:
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  3. ETISH:
    One side of the body systemsHerpes.
  4. kalibr:
    But it can shorten the duration of the infections and.