Composite laser to subdue the “waist-tangling dragon”
Linlin Xin, Department of Dermatology, Shandong Qianfo Mountain Hospital
Herpes zoster is commonly known as “tangled dragon”. It is a skin disease caused by varicella-zoster virus, which is usually treated with antiviral and pain relief, but the effect is not ideal, often the herpes goes down, but the pain is not reduced, which affects the patient’s daily life in serious cases, and a few people may have serious post-neuralgia. Our department uses compound laser combined with drugs to treat herpes zoster with satisfactory results. Xin Linlin, Department of Dermatology, Shandong Qianfo Mountain Hospital
The culprit – varicella-zoster virus
Herpes zoster is caused by the varicella-zoster virus. When first infected with the herpes zoster virus, the virus proliferates in the body, forming a viraemia that spreads throughout the body and causes chickenpox to occur. The specific immunity produced when suffering from chickenpox can prevent the recurrence of chickenpox after it has healed, but it cannot clear the virus latent in the ganglia because this virus is neurophilic, so it can persistently latent in the sensory ganglia of the posterior root ganglia of the spinal cord or cranial nerves. Some patients become viral carriers after infection and do not develop the disease, and the virus is latent in the ganglia for a long time. When the body’s immune function is weakened and resistance is reduced, the latent virus is activated and multiplies along the subcutaneous nerve endings, causing inflammation and necrosis of the affected ganglion, resulting in neuralgia and the appearance of herpes in bunches of bands along the innervated skin area.
The clinical manifestations of herpes zoster are varied and occur in spring and autumn, and are common in adults, especially in the elderly, the chronically ill, the physically fatigued, cancer, and people with colds. The skin is red at the onset, followed by clusters of red papules the size of corn to green beans, which rapidly evolve into round blisters within 1 to 2 days, with clarified herpes and shiny, tense walls, which later become cloudy or purulent. Clusters of herpes appear one after another along the nerve distribution, arranged in a band, but only on one side of the body and not across the midline of the trunk. Herpes zoster is often referred to as “herpes zoster” because it often invades the intercostal nerves and occurs in the lower back. However, herpes zoster can also be “tangled” and can occur on the head, face, neck, limbs, and even in the eyes, ears, and internal organs, in addition to the lower back. Ocular herpes zoster is caused by viral invasion of the trigeminal nerve and presents with swelling and pain in one eye, conjunctival congestion, photophobia and tearing, and clustered blisters in the cornea, supraorbital rim, nose, nostrils, temporal and hairline areas. If not treated promptly, the blisters can rapidly break down to form ulcerative keratitis, leading to blindness and, in severe cases, total uveitis. Ear herpes zoster is caused by viral invasion of the facial and auditory nerves and manifests as herpes in the external auditory canal with facial nerve paralysis and tinnitus and deafness in the affected area. Visceral herpes zoster is caused by the virus invading the visceral nerves, causing gastrointestinal and urinary tract symptoms such as abdominal pain, diarrhea, urinary frequency and urgency. When the lesion invades the pleura and peritoneum, chest pain, abdominal pain and even fluid accumulation in the chest and abdominal cavity may occur. Therefore, herpes zoster is often clinically reported to be misdiagnosed as coronary heart disease, pleurisy, cholecystitis, appendicitis, various internal stones and other diseases.
Typical symptoms – neuralgia
Neuralgia is the most typical symptom of the disease. Most of the pain occurs within 3 to 5 days before the appearance of the rash, and some of the pain accompanies the appearance of the lesions, especially in elderly patients, and the pain is as unbearable as soup splashing fire, or cone prick-like, and cannot sleep at night. In some patients, the neuralgia remains after the lesions have completely faded and can last for a long time, ranging from a few months to a year or two. Therefore, early treatment after the disease should be clinically observed, middle-aged and elderly people, especially those with herpetic herpes zoster, have the most intense pain and the longest residual neuralgia with improper treatment.
Best time to treat – within a week
The treatment of herpes zoster is based on the principles of pain relief, antiviral, anti-inflammatory, nerve nutrition and strengthening supportive therapy, of which pain relief and prevention of post-herpetic neuralgia are especially important. Although herpes zoster rarely causes systemic symptoms or complications, it seriously affects people’s daily life because of its heavy pain, so when there is a sudden red papular blister on the skin with pain, you should go to the hospital dermatology department in time The earlier the treatment is done, the better the effect, generally within a week of onset is the best time for treatment. Especially for middle-aged and elderly patients, there should be no delay. Early treatment and more recuperation is an effective way to avoid the legacy of stubborn herpes zoster neuralgia.
New method of pain relief – semiconductor compound laser irradiation
For the treatment of herpes zoster neuralgia and post-herpetic neuralgia and the prevention of post-herpetic neuralgia, there is now a scientific method of treatment and prevention – semiconductor compound laser irradiation. This method is to enhance the immunity of the body, promote the absorption of inflammation, reduce edema, and have a good effect on both the repair and regeneration of traumatic tissues through the biological and thermal effects of low-power laser. At the same time, it can reduce the chemical and mechanical stimulation of nerve endings at the injury site, regulate the excitability of nerve endings, enhance cellular vitality, promote metabolism, improve local tissue nutrition, and facilitate the growth and functional recovery of nerve cells, thus achieving anti-inflammatory, anti-swelling and analgesic effects.
Semiconductor compound laser irradiation treatment can be completed in the outpatient clinic, each irradiation 8 to 15 minutes, continuous 5 to 15 days will have a very significant effect. Combined with drug treatment is more effective.