Clinical manifestations and treatment of lumbar herpes zoster

The rash is generally unilateral and distributed according to nerve segments, composed of clustered herpes and accompanied by pain; the older the age, the more severe the neuralgia. So what are the clinical manifestations of lumbar herpes zoster? How to treat it?

Clinical manifestations

1. Typical manifestations

Before the rash occurs, there may be systemic symptoms such as mild fatigue, low fever, and poor appetite. The affected skin will feel burning or neuralgia, and there will be obvious pain sensitivity when touched, which lasts for 1 to 3 days. The rash may also occur without any prodromal symptoms.

The most common sites are the areas innervated by the intercostal nerves, cervical nerves, trigeminal nerves and lumbar sacral nerves. The affected area often first develops erythema, soon followed by millet- to soybean-sized papules, which are clustered and not fused, and then quickly turn into blisters with tense and shiny blister walls, clear blister fluid, and a red halo around the periphery. The skin between clusters of blisters is normal. The lesions are arranged in a band-like manner along a peripheral nerve, mostly on one side of the body, usually not exceeding the midline. Neuralgia is one of the characteristics of this disease, which may occur before the onset of the disease or accompany skin lesions, and is often more severe in elderly patients. The course of the disease is generally 2 to 3 weeks. After the blisters dry up and the scabs fall off, temporary light red spots or pigmentation remain.

2. Special performance

(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.

(4) Other atypical herpes zoster are related to the differences in the body's resistance of patients, and can 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.

Herpes zoster is commonly known as snake-like waist, waist sore, and jade belt sore. It is common in the waist and is divided into two types: dry and wet, presenting as a group of herpes. Patients will feel mild fever and general weakness within a few days. The dry type is red in color, shaped like a cloud, with chills and occasional itching. The wet type is white and yellow in color, with blisters that break and ooze yellow water, and occasional pain. If this condition is not treated in time, if it has spread all over the waist, it will inevitably lead to serious consequences, such as residual pain that will not heal for years.

Small side recipe

10 grams of realgar, 10 grams of raw dragon bone, and 3 centipedes.

usage:

Grind the above three ingredients into fine powder, mix it with sesame oil to dilute it into an ointment and apply it to the affected area twice a day. It will be healed in four days.

Realgar: Effects:

Detoxify, kill insects, dry dampness and eliminate phlegm, and stop malaria. Used for carbuncles, furuncles, snake and insect bites, abdominal pain caused by worm accumulation, epilepsy, and malaria.

Raw dragon bone: Efficacy:

The raw product can suppress yang and calm the mind, and is used for symptoms such as yin deficiency and yang hyperactivity, irritability, palpitations and insomnia, dizziness, epilepsy and shock; the effect of calcined product is to astringe and solidify the body, and is mostly used for spermatorrhea, premature ejaculation, leukorrhea, metrorrhagia, spontaneous sweating and prolonged diarrhea, eczema, itchy rashes, wounds that do not heal, and bleeding from external injuries. In addition, calcined and ground into powder for external use can absorb moisture and heal sores, and can also treat wet sores that do not heal over time.

Centipede: Effects:

Convulsions, epilepsy, spasms and convulsions, stroke, tetanus, rheumatism, hemicrania, snake bites, sores, and scrofula.