Herpes zoster neuralgia Herpes zoster is one of the most prevalent viral infections of the skin in the spring, caused by varicella-zoster virus infection that reoccurs latently in the body, resulting in clusters of herpes arranged in bands along the innervated skin area, accompanied by more intense neuralgia. The incidence of herpes zoster increases sharply with age, from 1 in 1,000 in children and adolescents to 4 to 12 in 1,000 over the age of 65, and more than 90% are seropositive for varicella zoster virus. The prevalence of acute herpes zoster is 50% in the chest, 3-20% in the forehead, 10-20% in the neck, and 5-15% in the lower extremities. The elderly and people with chronic wasting diseases are susceptible to shingles, and the disease is more serious once contracted. The folklore of this disease is known as “string waist dragon”, and in the literature it is called “tangled waist fire dan”, because herpes zoster that affects the chest and waist area accounts for more than 60% of the incidence of this disease. In fact, the disease can also invade the head, face, ears and upper and lower limbs. As the virus is nerve-friendly, it always develops along the nerves in a band, hence the name “herpes zoster”. In Chinese medicine, herpes zoster is thought to be caused by a strong fire in the liver and gallbladder and a long period of spleen and dampness, and is caused by external poison. Modern medicine has learned that the virus is invaded by respiratory infection and latent in the nerve cells of the posterior root ganglion of the spinal nerve or other sites of disease. This virus usually does not develop, but due to the elderly and the long-ill and weak people, the systemic resistance is reduced, and then encounter physical exertion, colds and malignant tumors and other triggers, then prone to this disease. Pathogenesis: Primary infection can occur in people with no or low immunity (mostly children) after virus infection, i.e. chickenpox. When the immunity of the body decreases (e.g., trauma, cold, cancer, immune system diseases, etc.), the latent virus multiplies and causes inflammation and necrosis of the ganglion, resulting in pain in the patient. The virus travels down the nerve pathway to the area innervated by that nerve and causes segmental herpes. The virus can also infect motor neurons, causing muscle weakness and motor paralysis, but this is rare. At the onset of the disease, the main symptoms are generalized fatigue, loss of appetite, mild fever, and soon a burning, throbbing, or pins-and-needles pain at the site of the disease. If it occurs in the chest or lower back, it is often misdiagnosed as heart disease or acute abdomen, etc. When you have herpes zoster, 1 to 3 days later, the skin of the onset site is covered with green pea-sized, highly tense papules and blisters, which are distributed along the nerves and arranged in clusters in a striped pattern. If it occurs on the chest or waist, it is more likely to occur from the side of the spine diagonally downward, and rarely symmetrically. The folklore that a circle of herpes around the waist is life-threatening is not reliable. In mild cases, each cluster can be spaced with normal skin, but in severe cases, they can be fused into a large band-like distribution, and after a few days, they can change from clear blisters to cloudy pustules, and some can break down to form vesicles. In the elderly, the disease is often characterized by large, bloody blisters and even necrosis. In mild cases, the blisters dry up naturally in about three weeks and crust over, leaving no scar after shedding; in severe cases, the course of the disease can extend to more than one month. Elderly patients often have severe pain that affects their sleep, and if treatment is not early and timely, the pain remains after the lesions have subsided and does not completely subside for months or even years, resulting in great pain for the patient. If herpes zoster appears on the head and face, be alert for headaches and facial paralysis due to invasion of the head and facial nerves. If the cornea of the eye is invaded, it can even lead to blindness. The condition can be more severe in older, weaker people and those with chronic diseases such as tumors. It is important to note that there is also an incomplete form of herpes zoster, where the blisters do not appear or appear rarely, except for severe pain at the onset of the disease, which can be easily misdiagnosed and should be taken seriously to avoid delaying treatment and finding serious consequences. Patients with herpes zoster should be diagnosed by a pain physician as soon as the site pain appears, and early antiviral and nerve block treatment should be administered to effectively relieve and eliminate the pain, and more importantly, to greatly reduce the incidence and pain level of post-herpetic z neuralgia.