Wang Shu, Department of Dermatology, Ningguo People’s Hospital: Herpes zoster is a disease caused by varicella-zoster virus infection, with the initial infection of the virus manifested as chickenpox; recurrent infection as herpes zoster. The clinical manifestations of herpes zoster are characterized by clusters of papules, papules or blisters on the skin and mucosal surfaces distributed unilaterally along the peripheral nerves of the torso, often accompanied by severe pain (neuralgia). In a small number of patients, the rash may extend beyond the midline of the torso, and in a very small number of patients, there is no characteristic rash at all, but only severe pain, which needs to be carefully identified and clearly determined. Depending on the severity of the herpes zoster disease, the clinical categories are: rashless (pain without rash), dacryocystic (erythema without papules or blisters), maculopapular, hemorrhagic (bloody herpes), necrotic, and disseminated (varicella-like rash on the skin and mucous membranes with visceral dissemination, severe systemic toxicity, and a high mortality rate). The duration of herpes zoster is usually 2-3 weeks, but in some cases the duration of the disease is significantly prolonged and the pain is severe and unbearable. After the rash of herpes zoster subsides, some patients often have residual neuralgia in the original affected area, which is caused by post-inflammatory damage to the nerve fibers. The pain varies in severity, and in some patients it can last for months or even years, causing pain and inconvenience to the patient and his or her family. Patients with herpes zoster should have early antiviral treatment after diagnosis: early use (within 72 hours of onset) of acyclovir, or famciclovir, or valacyclovir, or ganciclovir sodium have good antiviral efficacy. Failure to administer antiviral therapy in a timely manner can lead to multiple complications and time to remission of neuralgia. Early and aggressive antiviral treatment can significantly shorten the course of the disease and reduce neuroedema and relieve pain. Patients with severe herpes zoster with a generalized rash are recommended to use nerve-nourishing drugs such as vitamin B1 and methylcobalamin tablets, as well as nerve-nourishing drugs with vasodilating effects such as epalrestat. Depending on the patient’s condition, pain relief or analgesic drugs are actively administered orally or by injection. We routinely give vinclofenac enteric tablets or tramadol hydrochloride, which have good pain relief effects. When I treat patients with shingles, I often recommend: topical application of Mabel’s moist burn cream to the rash. The use of this drug not only has a certain pain-relieving effect, but also promotes rapid fading and healing of the shingles rash, and has the effect of preventing skin infection in the affected area. We also often treat severe herpes zoster patients with early use of glycyrrhizin, an extract of licorice, which can replace glucocorticoids and speed up the regression of peripheral nerve edema that dominates the lesions and is beneficial in reducing pain. Finally, for some patients with severe disease, physical therapy such as helium-neon laser irradiation and UVB irradiation are also recommended. All of these methods are effective and can significantly shorten the course of the disease. In a very small number of patients with severe post-neuralgia, local skin closure or nerve block therapy can be performed if conventional analgesic treatment is ineffective. These are the common methods of clinical treatment for herpes zoster, which are effective for most patients. I hope the patient will recover soon and get rid of the disease! Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): I caught a cold on October 11, then found bubbles and pain in the anal sulcus, and by October 16, I went to the Datong Mining Bureau Hospital for examination, and it was called herpes zoster. There was also herpes zoster on the belly and neck, and he was admitted to the hospital on October 19, and the pain is still quite severe until today. Patient Zhang, female, 68 years old. How to treat?