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Background: Herpes zoster (HZ) is an acute, inflammatory, viral skin disease caused by the varicella - zoster virus which mainly happens in spring and autumn. The main feature of the disease is a cluster of blisters, neuralgia and herpes zoster neuralgia sequelae (postherpetic neuralgia, PHN). Most of the occurrences of HZ are related to cold, fatigue, stress, trauma, cancer, various infections and systemic diseases, which low the body’s immune system. After primary infection in the immunocompromised populations, it shows varicella or latent infection in clinical. Then the virus enter into the sensory nerve endings of the skin, move to the center along the dorsal root of spinal cord or the nerve fibers of trigeminal ganglion, lurk in the ganglion neurons of the dorsal root. When stimulated by various factors, the lurking virus re-activate, grow and reproduce, which causes the invasion ganglion inflammation necrosis, resulting in nerve pain.Objective: To analyze the general information and clinical characteristics of hospitalized HZ patients in order to explore the proposed causes and the related factors of HZ.Methods: Informations of 193 cases of hospitalized HZ patients during the years of 2009 to 2010 were retrospectively analyzed. Summarize the characteristics of age, predisposing factors, season features, distribution of lesions, disease type, symptoms, laboratory tests, complications and treatments.Results:1. General Information: 193 cases of HZ patients meet the diagnosis, 82 cases of male, 111 cases of female, the ratio is 0.74:1. Age, 37 cases from 16 to 45 years, 43 cases from 46 to 60 years old, 113 cases from 61 to 90. Most of the patients happen in spring and autumn.2.Predisposing factors: 24 cases of patients complained fatigue, mood swings, mental stress or work pressure, etc prior to the onset, 9 cases of patients had an irregular life before the onset, 4 cases of patients had an upper respiratory tract infection history, 16 cases of patients had an operation before the onset, 6 cases of patients had pulmonary disease history prior to the onset, 14 cases of patients had one or two diseases. 4 cases of patients were detected urinary tract cancer during hospitalization, 30 cases of patients do not have a clear incentive.3. Clinical features:1) The distribution of the lesions 44 cases of patients distribute among the trigeminal nerve distribution areas, 56 cases among sternocostal nerve distribution area, 50 cases among waist, neck, 28 cases among neck and upper limb, hip, 15 cases among leg areas.2) Clinical classification 169 cases of usual type, 7 cases of bullous type, 5 cases of Pan-onset type, 5 cases of eye type, 2 cases of ear type and 5 cases of hemorrhagic type.3) Conscious symptoms 148 cases had perceived pain, 56 cases affected sleep severely. Patients younger than 30 years are with mild pain, patients between 31 to 5o are mostly with moderate pain, patients over than 50 years are more intense. 114 cases of patients have herpes neuralgia first, 43 cases of patients have rashes first, while 36 cases of patients have both of them together.4) Laboratory examination 108 cases of patients have a drop of white blood cell count and (or) an increase of proportion of lymphocytes, 55 cases of patients have a increase of monocytes. 7 patients tested T lymphocyte subsets in peripheral blood simultaneously, 1cases of patients was normal, 4 cases of patients had a decline in CD4, 2 cases of patients had an increase in CD8, the rate of CD4/CD8 had a declined tendency.5) 34 cases of patients had a varying degrees of heat. 6 cases of patients complicated with infection on the site of lesions. 3 cases of patients complicated with oral viral herpes, 1 case of patient complicated with glaucoma in ipsilateral lesions, 4 cases of patients complicated with ocular viral conjunctivitis, 2 cases of patients complicated with Ramsay-Hunt syndrome. 82 cases of patients had different degrees of cardiovascular and cerebrovascular disease. 4 cases of patients were detected urinary tract tumors in the hospital during abdominal and urinary ultrasound test. 4 Treatments: Treat with the routine anti-virus, nutrition nerves, regulating immunity, topical cream, microwave, acupuncture, cupping and so on. Patients with severe herpes, patients with obvious pain should be injected with recombinant human interferonα2b injection intramuscular everyday, which can be used for 7 days without sustained high fever. For the older patients, HZ of head and face, with a larger lesion, significant pain, without a contraindications of corticoids, an early use of dexamethasone (5~10mg) should be added, and then reduce the dose when the neuropathic pain relief.Conclusions: HZ is a common viral skin disease, mainly occurs in the spring and autumn, the incidence of HZ increases with increasing age. There ate various manifestations in clinical, the severity of symptoms are related by age and constitution. Patients of HZ diagnosed clearly should be treated as soon as possible. Patients of HZ of head and face or with old age or severe symptoms should add a small amount of corticosteroids, which can reduce inflammation and neuropathic pain and prevent the occurrence of postherpetic neuralgia. Do a system checks at the same time, in order to exclude or find other chronic wasting diseases such as a possible of tumor.
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