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Update Date: 2024-06-06 Source: Network

Herpes Zoster, Commonly Known as "Fei She Dan"

Herpes zoster, commonly known as "Fei She Dan" or "Fei She Dan Chuang" in folk medicine, is an acute infectious skin disease caused by the varicella-zoster virus. Antiviral drugs such as acyclovir can be used to treat herpes zoster, along with analgesics like fentanyl and tramadol to alleviate pain symptoms. Surgical nerve blockade may be considered when severe pain is difficult to control with medication. Children who have no immunity to this virus may develop varicella after infection, while some infected individuals may become asymptomatic carriers. Prior to the eruption of herpes zoster, patients may experience mild fatigue, low fever, poor appetite, and other general symptoms. The affected skin may feel hot or painful, with increased sensitivity to touch lasting for 1 to 3 days. There may also be no prodromal symptoms before the rash appears. The most commonly affected areas are the intercostal nerves, cervical nerves, trigeminal nerves, and lumbosacral nerve innervation regions.

Due to the neurotropism of the virus, it can remain latent in the neurons of the posterior root ganglia of the spinal cord after infection. When resistance is low or due to fatigue, infection, or colds, the virus can regrow and multiply, migrating along nerve fibers to the skin, causing intense inflammation in the affected nerves and skin.

1. Drug Therapy:

Antiviral drugs such as acyclovir, valacyclovir, or famciclovir can be used.
Neuralgia drug treatment includes antidepressants (e.g., paroxetine, fluoxetine, fluvoxamine, sertraline), anticonvulsants (e.g., carbamazepine, sodium valproate), narcotic analgesics (e.g., morphine, oxycodone, fentanyl, dihydroetorphine, lugec), and non-narcotic analgesics (e.g., NSAIDs, tramadol, aconitine, capsaicin).

2. Surgical Nerve Blockade:

When severe pain is difficult to control with medication, surgical nerve blockade, a direct and effective sensory nerve block therapy, should be considered. The choice of blockade localization depends on the lesion range and treatment response. The general principle is to proceed from superficial to deep, from simple to complex, and from peripheral nerves to nerve trunks and nerve roots. Radiofrequency thermocoagulation for nerve destruction is the most direct and effective treatment method. Other nerve destruction treatments include stereotactic radiosurgery of the medial thalamus (gamma knife or X-knife), surgical destruction of the dorsal root of the spinal cord in the subdural space, pituitary destruction, and destruction of sympathetic ganglia.