Upon the diagnosis of herpes zoster, an appropriate initial herpes zoster treatment should be initiated as soon as possible. Herpes zoster is a viral disease that causes pain and rash. The lesions appear as clusters of vesicles with erythematous bases. They usually occur on adjacent dermatomes in the thoracic or lumbar regions and remain for three to five days. In immunocompromised individuals, the disease may disseminate to other parts of the body including the viscera.
Trigeminal herpes zoster
Initial treatment of trigeminal herpes zosters is essential to prevent long-term neurological sequelae. Left untreated, the disease can lead to encephalitis, postherpetic neuralgia, and permanent vision loss. Thus, early diagnosis and high-dose antiviral therapy are essential. The use of empirical antibiotics may delay antiviral therapy.
The onset of pain in patients with herpes zoster varies, and symptoms can be mild or severe. Mild herpes zoster pain can be treated with over-the-counter analgesics, while severe cases may require narcotics. Patients should be prescribed the proper dose of antiviral medications and have regular dosing schedules to reduce the anxiety and pain. In addition to oral medications, topical ointments can be applied to crusted lesions to reduce pain. In addition, nerve blocks are effective in reducing the pain associated with herpes zoster.
Initial treatment for herpes zoster should be determined by an ENT specialist and neurologist. A combination of intravenous acyclovir and systemic corticosteroids may be used in severe cases. Oral acyclovir may also be used in the short-term for relief of acute pain.
Ophthalmic dermatitis of the external ear canal
In patients with herpes zoster, the external ear canal may become inflamed, and a common variant is ophthalmic dermatitis of the external auditory meatus. This condition is often associated with pain in the external auditory meatus and loss of taste in the anterior two-thirds of the tongue. It can also lead to ipsilateral facial palsy. Treatment for herpes zoster in children generally involves a multidisciplinary approach and often begins in the primary care office. In the case of acute disease, the primary care provider should initiate antiviral therapy. Pharmacists are available to help with dosing regimens and can advise about pharmacodynamic interactions. In severe cases, the patient should be hospitalized or consult with
Despite the low occurrence of herpes zoster, the condition is associated with a high complication rate. About 10 to 20 percent of cases show ocular involvement, and one-half exhibit cutaneous lesions. Ophthalmic dermatitis is common, but patients can also experience delayed keratitis or scleritis. Other complications include optic neuritis, optic neuropathy, and acute retinal necrosis.
Postherpetic neuralgia
Herpes zoster is a relatively common disease, and postherpetic neuralgia is a common side effect. It is important to treat this condition as early as possible after a person develops the rash, as it can be debilitating. Treatment options include oral acyclovir and oral corticosteroids. Antiviral drugs are most effective when started within 72 hours of the onset of the rash. Anticonvulsants and tricyclic antidepressants may also be used to manage neuropathic pain.
Symptomatic postherpetic neuralgia may last for weeks or months. If the pain doesn’t go away within a month, the patient should contact their healthcare provider. Treatment for postherpetic neuralgia isn’t always simple, but it can be effective. It is important to take the medication as prescribed.