(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: A 42-year-old male with blisters of a painful nature on the skin surface and surrounding normal skin accompanied by radiating pain is suffering from herpes zoster, a viral infection, which itself is a contact infectious disease. The patient found symptoms to seek medical attention, timely selection of antiviral drugs and nerve-nourishing drugs after a combination of treatment, the condition gradually remission.
Basic information】Male, 42 years old
Disease Type】Herpes zoster
Hospital】Harbin Hospital of Traditional Chinese Medicine
Date of consultation】May 2022
Treatment plan】Medication (vaxilovir hydrochloride tablets + vitamin B1 tablets + vitamin B6 tablets + vitamin B12 tablets + glyburide lotion + penciclovir cream + pregabalin capsules)
[Treatment Period] 30 days of home treatment
Treatment effect】The blisters on the skin surface gradually dried up and the pain gradually disappeared
I. Initial consultation
In mid-May, a middle-aged male of about 40 years old came into the clinic with a painful expression. The patient described the appearance of red spots on the skin surface three days ago, accompanied by cutting pain, and within three days, the symptoms on the skin surface gradually worsened and expanded in size, with the appearance of small blisters. Adjacent parts of the skin surface without blisters, such as the lower part of the chest, arms and elbows, also showed inexplicable pain. The examination revealed a dense arrangement of small blisters on the skin surface, distributed in strips on the anterior chest as well as on the left wrist. The first impression I got from the patient’s clinical presentation was that herpes zoster was a frequent disease in spring. After communicating with the patient and explaining the judgment of the disease and the development pattern of herpes zoster, the patient agreed to perform routine blood tests for preliminary diagnosis, and the results of routine blood tests showed a decrease in neutrophils, consistent with symptoms of viral infection, and considered herpes zoster as a viral skin disease.
II. Treatment history
After the herpes zoster test results supported the diagnosis, the patient was communicated with to determine the treatment plan. The patient was advised to take oral vaxilovir hydrochloride tablets for antiviral treatment, as well as oral vitamin B1 tablets, vitamin B6 tablets, and vitamin B12 tablets to nourish the nerves and relieve neuropathic pain. Topical application of glyburide lotion should be applied to localized skin blisters. After the blisters have dried up, topical penciclovir cream is applied to allow the drug to penetrate through the skin cell spaces and provide antiviral treatment from the outside in. In case of severe pain, the oral analgesic drug Premarin capsules may be chosen to relieve the discomfort caused by the pain. The overall treatment period is relatively long, and patients are instructed to be patient with the medication and use it for the full course of treatment. After the patient got the medication and understood the medication process, the patient was informed that herpes had appeared for 3 days and the symptoms might gradually worsen in the next 4-7 days, and the pain might persist with or without medication, and that regular medication would gradually relieve the pain, and the patient went home for medication treatment after expressing his knowledge.
III. Treatment effect
The patient described that the symptoms gradually worsened within 3 days of medication, but after 7 days of medication, the symptoms gradually subsided, the pain subsided significantly, and the blisters dried up. About 10 days after the drug was administered, there was mild peeling of the local blister area. By the date of the telephone call, the painful symptoms on the skin surface had basically subsided, no new blisters were seen, and the blisters on the original site had completely disappeared. The patient was instructed to continue the medication for a full course of 30 days and to come back to the hospital for a review in 30 days.
IV. Precautions
The patient’s discomfort improved significantly after the treatment, and we are truly happy for the patient. Since this disease is contagious by contact to a certain extent, it is recommended that patients should not use their affected skin to have intimate contact with other people’s skin before the disease is completely cured to prevent the infection to others. Bed sheets, covers, and clothing that are in contact with the disease in daily life should be disinfected regularly to avoid indirect infection caused by contact with certain items. This disease is prone to residual post-neuralgia, and it is recommended to follow the doctor’s instructions for a full course of treatment, which will reduce the probability of residual post-neuralgia. This disease is the same virus as chickenpox, so patients with children at home should avoid close contact with them to prevent them from developing chickenpox. If you experience any discomfort while taking the medication, seek medical attention promptly.
V. Personal insight
Herpes zoster itself is a disease caused by the varicella-zoster virus that infects the human body and is prevalent in the spring. The probability of this disease is relatively high among the elderly, so it is recommended to improve immunity during the treatment of the disease, do not drink excessively and do not stay up late to prevent the lowering of immunity and prolong the treatment period of the disease. In the early stages of herpes zoster, changes such as erythema and papules will appear on the skin surface, which can easily lead to misdiagnosis. Once symptoms similar to neuralgia appear, it is important to go to the hospital for routine blood tests in order to make a clear diagnosis and treat the disease as soon as possible. Individuals with shingles who have no skin manifestations and have only localized pain should consult a specialist for early treatment and should not delay treatment.