Herpes zoster and postherpetic neuralgia

  Herpes zoster and chickenpox are different clinical manifestations caused by the same virus (varicella-zoster virus). Children who are not immune to the virus are infected with the virus, which enters the body through the mucous membranes of the respiratory tract and spreads through the bloodstream, resulting in chickenpox. In some children, 30% of the infected children do not have clinical symptoms (latent infection), but because of its neurophilic nature, it can be latent in the neurons of the posterior roots of spinal nerves or brain ganglia for a long time. Herpes zoster is caused in this nerve area.  Herpes zoster can cause neuritis and gangliositis in the acute phase, and can be accompanied by severe neuralgia in patients over 40 years of age. The neuralgia is particularly severe and common in older patients (around 30%). Some of them can be delayed for several years or decades. It is one of the persistent pains that plague middle-aged and elderly people. Patients suffer from chronic pain, which not only depresses their mood and quality of life, but also reduces or even loses their ability to work and socialize. In addition, unlike acute herpes zoster, patients with postherpetic neuralgia often have a combination of abnormal psychological factors. Due to the long-term severe pain, patients are psychologically burdened, depressed, lose confidence in life, and most have suicidal tendencies.  The onset of the disease is often preceded by local sensory allergy or neuralgia, mild fever, general malaise, loss of appetite and other prodromal symptoms, or sudden onset without prodromal symptoms. The affected area first develops flushed patches, followed by clusters of red papules the size of a corn, which rapidly turn into blisters. The incidence of acute herpes zoster and postherpetic neuralgia is increasing with the development of the average age of the population, and the treatment of postherpetic neuralgia is still very difficult.