Differentiation of Syndrome in Traditional Chinese Medicine for Herpes Zoster

Many people may not have heard of herpes zoster and are very unfamiliar with this disease. In fact, this is the shingles often mentioned in medicine. The onset of this disease is relatively acute. Every time the disease occurs, the patient will feel inflammation in his joints, feel abnormal pain, and often catch a cold and feel tired.

Clinically, it often presents as several clustered herpes groups arranged in bands, distributed along the peripheral nerves, often unilaterally, generally not exceeding the midline of the body surface, and mostly distributed in irregular bands. It is common in the chest, abdomen, back and face. There is a burning sensation on the local skin, accompanied by neuralgia. At the beginning of the disease, the main symptoms are general fatigue, loss of appetite, and mild fever. Soon the affected area will feel burning and throbbing pain. If it occurs in the chest or waist, it is often misdiagnosed as heart disease or acute abdomen.

(1) Herpes zoster ophthalmicus is caused by a virus that invades the ophthalmic branch of the trigeminal nerve. It is more common in the elderly and causes severe pain. It can also affect the cornea and form ulcerative keratitis.

(2) Herpes zoster oticus is caused by a virus invading the facial nerve and auditory nerve, and manifests as herpes in the external auditory canal or tympanic membrane. When the geniculate ganglion is affected and the motor and sensory nerve fibers of the facial nerve are invaded at the same time, a triad of facial paralysis, ear pain, and external auditory canal herpes may occur, which is called Ramsay-Hunt syndrome.

(3) Postherpetic neuralgia: Herpes zoster is often accompanied by neuralgia, which can occur before the rash, during the rash, and after the skin lesions have healed. However, it usually disappears after the skin lesions have completely subsided or within 1 month. In a few patients, the neuralgia may last for more than 1 month, which is called postherpetic neuralgia.

Other atypical herpes zoster are related to differences in the body's resistance of patients, and may manifest as abortive type (no skin lesions, only neuralgia), incomplete type (only erythema and papules appear without blisters and then disappear), bullous type, hemorrhagic type, gangrenous type and generalized type (simultaneous involvement of more than two ganglia, resulting in skin lesions in multiple areas on the contralateral or ipsilateral side). The virus can occasionally spread through the blood to produce widespread varicella-like rash and invade organs such as the lungs and brain, which is called disseminated herpes zoster.