Herpes zoster is an acute inflammatory skin and nerve damaging disease caused by the varicella zoster virus. The disease is caused by the varicella zoster virus. The virus enters the body through the respiratory mucosa and spreads through the bloodstream, appearing on the skin as chickenpox, but most people are infected and do not develop chickenpox as a recessive infection, becoming a carrier of the virus, which is neurophilic and invades the sensory nerve endings of the skin, and then moves along the nerves to the ganglia of the posterior roots of the spinal cord, where it lurks. In rare cases, the herpes virus can spread to the anterior horn cells of the spinal cord and visceral nerve fibers, causing motor nerve palsy, such as oculofacial nerve palsy, as well as gastrointestinal and urinary tract symptoms. The disease is often sporadic and is related to the immune function of the body. In the elderly, after local trauma, systemic lupus erythematosus, lymphoma, leukemia and patients receiving corticosteroids, immunosuppressive drugs and radiation therapy for a longer period of time, they are significantly more susceptible than normal people, and the disease is prolonged and severe, with more prominent posterior neuralgia. It is more common during seasonal changes. It is generally self-limiting. Herpes zoster can develop throughout the body, preferably on the chest, head, face, and lower back, and usually only on one side of the body. Clinical manifestations Before the onset of herpes zoster, there is often hypothermia, malaise, pain at the site of the rash, nociceptive hypersensitivity, pain can be burning, electric shock-like, cutting-like severe pain. The pain can be constant and worsens in paroxysms. The pain can be aggravated by rubbing of clothes, deep breathing, etc. The pain is worse at night and may interfere with sleep. The rash usually appears within 4-7 days of the onset of pain as a banded, segmental, confined, unilateral cluster of small corn-like blisters based on erythema along the affected nerve. Development usually stops after 7-10 days and the rash resolves in 3-6 weeks. Herpes zoster usually presents as the following types: 1. Incomplete herpes zoster (strophic type): no local rash or only erythema or papules? without typical blisters, and quickly resolves on its own. 2. Herpes zoster with large blisters: large blisters larger than 0.5 cm in diameter, such as the size of a cherry, may appear. 3. Hemorrhagic herpes zoster: the blister content is bloody or forms a blood crust. 4. Gangrenous herpes zoster: the center of the rash can be necrotic, with a dark brown crust that does not peel off easily and can leave a scar when it heals, mostly in the elderly and malnourished patients. 5. Pancystic (disseminated) herpes zoster: the condition is severe and death has been reported. This type is rare. The time from localized rash to dissemination throughout the body is about 1-10 days, with clusters of blisters and a tendency to fuse? It can involve the lungs, brain and other organs, often with symptoms of central nervous involvement such as high fever and headache, mostly in debilitated elderly people and patients with malignant lymphoma. 6, ocular herpes zoster (trigeminal nerve ophthalmic branch): mostly seen in the elderly, severe pain, can involve the cornea, conjunctiva, iris ciliary body, sclera and other inflammation, and even total uveitis, resulting in blindness. Upstream infection can cause meningitis and death. 7. Herpes zoster of the ear (Ramsay hunt syndrome): that is, facial paralysis, deafness, external auditory canal herpes triad. Herpes zoster virus invades the posterior root of the geniculate ganglion and causes facial and auditory nerve involvement. It is characterized by unilateral facial palsy, external auditory canal herpes, tympanic membrane herpes with affected ear pain, tinnitus, deafness, mastoid pressure pain, impaired taste in the anterior 1/3 of the tongue, often accompanied by vertigo, nausea, vomiting, and nystagmus. 8. Visceral herpes zoster: rare. Herpes zoster virus invades the posterior root ganglion of the spinal nerve causing a rash in the area innervated by sympathetic and parasympathetic visceral nerve fibers? Gastrointestinal and urinary tract symptoms appear, segmental gastroenteritis and cystitis may occur; if the invasion of the thoracic and peritoneal membranes? cause inflammation or effusion of the thorax and peritoneum. Diagnosis basis 1. Unilateral neuralgia without obvious cause: local pain, pressure pain, skin nociceptive hypersensitivity, pain can be burning, electric shock-like, cutting-like severe pain. It can be persistent pain with paroxysmal aggravation. The pain increases at night and can affect sleep. 2. The rash usually appears within 4-7 days of the pain, and is banded, segmental, confined, and unilaterally distributed on the basis of erythema with clusters of small corn-like blisters along the affected nerve. 3. Most often seen in immunocompromised patients with a history of diabetes mellitus, hematologic disease, and tumors; 4. Imaging examinations to exclude infectious and occupational history. Auxiliary examinations: X-ray, MRI and other impact examinations; blood routine, ESR, CRP, liver and kidney function, etc. Exclude infectious and occupying lesions. Treatment principles: antiviral, prevention and control of neuralgia and herpes complications. Treatment 1, early application of acyclovir and other drugs antiviral treatment for 5-10 days. 2.Treat the lesions with topical wound treatment ointment and other drugs; give analgesia, nerve nutrition and symptomatic support treatment. Pregabalin capsules, oxcarbazepine and other drugs can be given to treat neuralgia. Prevent and treat local infection, ocular herpes, viral meningitis and other complications. 3. If there is no contraindication, early nerve block treatment can provide rapid analgesia, shorten the course of disease, reduce nerve damage and reduce the occurrence of postherpetic neuralgia. Patients with herpes zoster usually have low immunity and need to strictly comply with the principle of aseptic operation and apply antibiotics for 3 days after surgery to prevent infection. 4. If persistent post-herpetic neuralgia occurs, radiofrequency thermal coagulation of nerves, intrathecal morphine pump or spinal cord electrical stimulator implantation is feasible.