Publicação
Diagnosis and management of herpes zoster by the family and community physician
| Resumo: | The herpes virus that causes varicella (chickenpox) persists in a latent form in the nervous system and can reactivate and propagate through nerve roots, manifesting years later through painful skin lesions, a condition called herpes zoster. The diagnosis is primarily clinical, but it is important to make a differential diagnosis with impetigo, contact dermatitis, dermatitis herpetiformis and also herpes simplex itself. After the diagnosis is confirmed, treatment should be initiated within the first 72 hours after onset of the rash and it is based upon antiviral therapy. Valacyclovir and famciclovir are more effective when compared to acyclovir. The most common complication of herpes zoster is post-herpetic neuralgia, usually managed with tricyclic antidepressants, anticonvulsants, topical lidocaine or capsaicin. Recently, a live attenuated vaccine against herpes zoster was introduced in Brazil, with the same components as the vaccine against varicella, but in a greater concentration. However, it still has a high cost and is not available in the public health system. |
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| Autores principais: | Coelho, Pedro Alexandre Barreto |
| Outros Autores: | Coelho, Priscila Barreto; Carvalho, Natalia de Campos; Duncan, Michael Schmidt |
| Assunto: | Herpes Zoster Therapeutics Primary Health Care Herpes Zóster Terapéutica Atención Primaria de Salud Herpes Zoster Terapêutica Atenção Primária à Saúde |
| Ano: | 2014 |
| País: | Brasil |
| Tipo de documento: | artigo |
| Tipo de acesso: | unknown |
| Instituição associada: | IBICT |
| Idioma: | português |
| Origem: | Oasisbr |
| Resumo: | The herpes virus that causes varicella (chickenpox) persists in a latent form in the nervous system and can reactivate and propagate through nerve roots, manifesting years later through painful skin lesions, a condition called herpes zoster. The diagnosis is primarily clinical, but it is important to make a differential diagnosis with impetigo, contact dermatitis, dermatitis herpetiformis and also herpes simplex itself. After the diagnosis is confirmed, treatment should be initiated within the first 72 hours after onset of the rash and it is based upon antiviral therapy. Valacyclovir and famciclovir are more effective when compared to acyclovir. The most common complication of herpes zoster is post-herpetic neuralgia, usually managed with tricyclic antidepressants, anticonvulsants, topical lidocaine or capsaicin. Recently, a live attenuated vaccine against herpes zoster was introduced in Brazil, with the same components as the vaccine against varicella, but in a greater concentration. However, it still has a high cost and is not available in the public health system. |
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