带状疱疹
HuangKun
合库
HerpesZoster
TeachingContents
VDefinition
VEtiology
VPathogenesis
VClinicalmanifestations
VDiagnosis
VDifferentialdiagnosis
VTreatment
Definition
HerpesZosterisaviralinfection病毒感染
characterizedbyneuralgicpain神经痛and
clusteredvesicles水泡丛生situated位于
unilaterallyalongthedistributionofasensorynerve感觉神经.
Humanherpesvirustype3
(HHV-3)
Varicella-ZosterVirus水痘-带状疱疹病毒(VZV)
Pathogenesis
Varicella
水痘
Dorsalrootganglion
背根神经节
Latentinfection
潜伏感染
Herpeszoster
Pathogenesis
ThefollowingmaycausetheVZVtobecomeactive:
●Aging衰老
●Stress应激
●Fatigue疲劳
●Diseasesthataffecttheimmunesystem
●Anticancer抗癌的andimmunosuppression免疫抑制treatments
Lesions损伤
Ophthalmic眼zoster
Otic耳zoster
postherpeticneuralgia
带状疱疹后遗神经痛(PHN)
others
Typicalmanifestations
Specialmanifestations
ClinicalManifestations
Symptoms
TypicalManifestations—symptoms
Prodrome前驱症状：fever,headache,malaise不适
sensationsofburningpain,itching瘙痒，hyperesthesia感觉过敏
Pain:characteristicsymptom特征性症状
precedes首发oraccompanies伴随theeruptionofrash皮疹moresevereinolderpatients
usuallysubsides平息beforetherashhashealed
TypicalManifestations-lesions
erythema红斑andpapules丘疹
12-24hs
clusteredvesicles水泡丛生
3-4ds
pustules脓疱
7-10ds
crusts结痂
scar瘢痕
TypicalManifestations-lesions
Distribution:unilateral(ononesideofthebody)
dermatomal皮区的(anareaofskin
suppliedbyonespinalnerve脊神经)
C4
Cs
T3
T1c6
L2
L3
C4
cs/
T2
C6/T1
L2
L3
Dermatome皮节
□Ophthalmic
Maxillary
Mandibular
Ramusofvagus■Auricular
2
3
4
5
6
7
B
0
10
11
12
L1
S1
L5L5
L5
L4
33)
aa
的8
15
L4
Ca
Siteofpredilection好发：
Thoracic胸部dermatome
Cranial颅部dermatome
(trigeminalnerve三叉神经)
Lumbar腰部dermatome
Sacral骶部dermatome
TypicalManifestations-lesions
55%
20%
15%
5%
Potentiallythemostdevastating破坏性formofherpeszoster.
Theophthalmicbranchofthetrigeminalnerve三叉神经眼支is
affected.
Conjunct