Shingles


 

Etiology

Shingles is a recurrent, painful, eryhtematous vesicular eruption caused by the reaction of latent varicella-zoster virus in an individual who had chickenpox years earler. It most often appears as a band of blisters that wraps from the middle of your back around one side of your chest to your breastbone. Although it is most common in people over age 50, anyone who has had chickenpox is at risk for developing shingles. Shingles is also more common in people with weakened immune systems from HIV infection, chemotherapy or radiation treatment, transplant operations and stress.

Chinese medicine believes shingles are caused by the following factors: 

o        Wind Heat.

o        Damp Heat.

o       Qi Deficiency

Pathologic changes in Shingle: Herpes Zoster virus inflamm the nerve tissue causing swelling and cutaneous lesions that resemble varicella along the nerve pathway. However the eruptions are limited to one or more sensory, and vesicles or bullae may be few.

Clinical Features

Shingles is usually unilateral but may be bilateral involvement. Most shingles are a once in a lifetime event, however some of the patients may experience multiple attacks. The most common symptoms are:

o        Buring pain, numbness or tingling

o       Red rashes start a few days after the pain

o        Fluid or blood filled blisters that break open and crust over

o        Itching       

Some people also experience:

o        Chills and fever

o        General achiness

o        Headaches

o        Fatigue

Diagnosis

o        A band of the telltale rash and blisters.

o        Burning neuropathway pain, long with enlargement of local limph nodes.

o        Normal skin structure in between the blisters.

Traditional Chinese Medicine differentiates Bell's palsy into three types:

o        Damp Heat

o        Toxic heat

o        Deficiency

Differentiation

o       On early stage: Intercostal neuralgia; pleuritist; acute abdominal conditions. 

o      On the blister stage:  The strong neuropathway pain will differentiate it from the simple contact dermatitis.

o      Blister fluid VZV, HSV antigens or DNA test are the only reliable ways of the differential diagnoses.

Treatment

Acupuncture treatment:

                o High frequency electro-acupuncture along the affected nerve roots.

                o Opposite side:  LU11, LI3, PC6, SP1, SP3 and SP6.

                o  For the difficulty cases, bleeding or fire needle Huatuojiaji. 

               o Fu's cupping 15' covering the blister area, upon removal of the cups, clean the fluid and apply the antibiotic creams on. 

Chinese Herbal Medicine: Shingle Herbal Formula. When taking this herbal formula, onions, hot peppers, sea food, red meats, vinigar and soil sauce are to be avoided for better recovery. Patient is also adviced to rest more.

In China, Vitamine B complex, antiviral medications, pain meds, for severe cases prednisone may be used. For the details, please call our office to schedule an appointment with MD on staff. 

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