Herpes

Herpes refers to diseases caused by viruses of the herpes virus family. Common clinical diseases include chickenpox, herpes zoster, herpes simplex, and genital herpes. It can invade multiple organs of the human body, and it can occur at any age.

Cause

Herpesviruses have the following common characteristics: ① The virus is spherical, and the surface of the virus nucleocapsid is asymmetrical octahedron composed of 162 shell particles, and the core is composed of DNA. There is a layer of lipoprotein envelope around the nucleocapsid, and the outer diameter of the virus is 150-200nm. ② Except for the EB virus, it can replicate in the nucleus of diploid cells, and eosinophilic inclusion bodies appear in the nucleus. ③The virus can spread directly through the intercellular bridge. Herpes virus mainly invades ectoderm-derived tissues, including skin, mucous membranes and nerve tissues. The herpes virus has three subfamilies: α, β, and γ, and those related to human infection include the following: Clinical manifestations

1. Varicella-disease caused by herpes zoster virus

(1) Shingles is an acute infectious skin disease caused by the varicella-zoster virus. Some patients become infected without symptoms. Because the virus is neurophilic, it can lie in the neurons of the spinal nerve root ganglion for a long time after infection. When the resistance is low or fatigue, infection, or a cold, the virus can grow and reproduce again and move along the nerve fibers to the skin. Causes intense inflammation of the affected nerves and skin. Skin rashes are generally unilateral and distributed according to nerve segments. The most common locations are the intercostal nerve, cervical nerve, trigeminal nerve, and lumbosacral nerve innervation. It is composed of clusters of herpes and is accompanied by pain; The larger the neuralgia, the heavier the neuralgia, and can cause neuralgia after herpes zoster. This disease occurs more often in adults and is more common in spring and autumn. The incidence rate increases significantly with age.

(2) Varicella-zoster uveitis can be congenital or acquired. Acute retinal necrosis syndrome caused by it has become an important blinding eye disease. The varicella-zoster virus isolated and cultured from the infected tissue can confirm the diagnosis. A slit-lamp examination can find anterior uveitis; fundus fluorescein angiography can find retinal vasculitis, retinal neovascular optic discitis and corresponding characteristic changes.

(3) The typical lesions of herpes zoster of the eyelid mostly occur in the skin distribution areas of the first branch of the trigeminal nerve (frontal nerve, lacrimal nerve and nasociliary nerve) or the third main branch (relatively rare). Cluster vesicular rash. But it does not cross the central boundary of the eyelid and nose but is limited to one side. It is more common in middle-aged and elderly patients. It rarely recurs after cure.

(4) Herpes zoster Auris was first described by Ramsey Hunt in 1907, so it is also called Ramsey Hunt syndrome or Hunt syndrome, or Hunter syndrome, which is a disease infected by the varicella-zoster virus. A group of special symptoms caused by facial nerve geniculate ganglion herpes virus infection mainly manifested as acute pain in one ear, herpes in the ear, peripheral facial paralysis on the same side, accompanied by hearing and balance disorders, so it is also called knee Ganglion syndrome.

2. Diseases caused by herpes simplex virus

(1) Neonatal herpes simplex is more common in premature infants and can also occur in term infants. Lesions often involve multiple organs throughout the body. 70% is caused by HSV-2 type, usually onset 3 to 5 days after birth, manifested as blisters and erosions on the skin, oral mucosa, and conjunctiva. In severe cases, it may be accompanied by fever, dyspnea, jaundice, hepatosplenomegaly, and consciousness Obstacles and so on.

(2) Pregnant women with genital herpes often have recurrent vulvar herpes before pregnancy. They are infected with the herpes simplex virus and are latent in the body, which is induced by the reactivation of the pregnancy virus. Commonly, there are 2 to 3 ulcers or blisters on the vulva, the disease course is short, and it heals naturally in about a week. If a pregnant woman is infected with the herpes virus for the first time in the first trimester of pregnancy (within the first trimester of pregnancy) and has obvious symptoms, it is prone to miscarriage or stillbirth. If a pregnant woman is infected with the herpes virus for the first time in the third trimester (the last trimester of pregnancy), the virus can be transmitted to the fetus, making the newborn susceptible to neonatal herpes, which may lead to the death of the newborn.

(3) Genital herpes, also known as genital herpes, is a sexually transmitted disease caused by herpes simplex virus (HSV), mainly HSV-2, and a few are HSV-1. It is one of the common sexually transmitted diseases. The disease is mainly transmitted through sexual contact. Patients and asymptomatic carriers are the main sources of infection. Genital herpes can occur repeatedly, which has a great impact on the health and psychology of patients; it can also infect newborns through the placenta and birth canal, leading to congenital infections in newborns. A burning sensation at the affected part first, followed by erythema; 3 to 10 clusters of red papules, accompanied by itching, soon occur on the basis of the erythema; the papules quickly turn into small blisters, and after 3 to 5 days they become pustules, broken Erosions and ulcers formed after ulceration, painful consciously, and finally, the scabs healed. the illness might last 20 days or so. Recurrent genital herpes occurs within 1 to 4 months after the onset. Recurrence mostly occurs in the vulva, vagina, cervix and glans. The systemic symptoms are milder than the original, and the course of each attack is shorter. The skin lesions usually disappear in about 10 days.

(4) Herpetic gingivostomatitis usually occurs in the mouth, gums, tongue, hard palate, and pharynx. It is manifested as clusters of small blisters that occur rapidly, which quickly rupture to form surface ulcers, and can also show as erythema and shallow ulcers at the beginning, with obvious pain. The natural course of the disease is 1 to 2 weeks. It can occur repeatedly in the same area under the stimulation of predisposing factors, which is called recurrent type, which is more common in adults.

(5) Herpes simplex encephalitis is the most common viral infectious disease of the central nervous system caused by herpes simplex virus infection. It often involves the temporal lobe, frontal lobe and limbic system of the brain, causing hemorrhagic necrosis of brain tissue and allergic brain damage.

(6) Vaccination herpes The skin lesions are clusters of blisters confined to the contact site. Those who occur on the fingers present with deep painful blisters called herpetic gangrene.

(7) Herpetic eczema often occurs in infants and young children with eczema or atopic dermatitis. It is mostly caused by HSV-1. It manifests as dense blisters or pustules that occur on the upper trunk, neck and head, fused into pieces, There is an umbilical cavity in the center of the blister, and there is a blush around it.

Reference:

Chen Yang, Zheng Maorong. Research progress in the pathogenesis and treatment of postherpetic neuralgia. 2002

Lin Zhimiao, Yang Yong, Li Ruoyu. Shingles and neuralgia. "CNKI", 2010

Huang Bing, Kong Jie, Lu Yaping, Sun Lei, etc. The characteristics and prevention of neuralgia after herpes zoster. "Chinese Clinical Rehabilitation", 2005

Gaodi, Li Ming. Post-herpetic neuralgia and its prevention. "International Journal of Dermatology and Venereology", 2002

Wang Jiashuang, Zhu Yueping. Clinical study on the long-term effect of neuralgia after herpes zoster. "Chinese Journal of Pain Medicine", 2001

疱疹 皰疹

疱疹是指疱疹病毒科病毒所致疾病。临床上常见的有水痘、带状疱疹、单纯疱疹、生殖器疱疹等疾病。可侵犯人体多个器官，任何年龄都可发病。