I-Shingles (Herpes Zoster): Izizathu, Iimpawu, kunye noPhando

I-Shingles (herpes zoster) ivela kwi-reactivation ye-varicella-zoster virus (VZV), ehlala ibhidden kwi-dorsal root ganglia kunye ne-cranial nerve ganglia ubomi bonke emva kokutheleleka kwe-chickenpox. Xa ubungakanani bokuzivikela buyehla, i-virus ingaphinda ivuselele kwaye ihambe ngama-fiber e-nervous sensory ukuya kwisikhumba, ibangele umkhono ojolise, obandayo ophakathi kwendawo ye-dermatome. Cinga ukuba omnye kumathathu abantu abake babe ne-chickenpox baya kuphumelela i-shingles ngexesha labo lokuphila — ikakhulu emva kweminyaka engama-50.

Uphindaphinda ukhuthazwa kukuncipha kokhuseleko lwezicubu. Iimpawu ezivamile kunye nezinto ezikhokelela emngciphekweni ziquka: ubudala obuphuhlisayo (umngcipheko omkhulu), ukunciphisa ukhuseleko ngenxa yemithi (i-corticosteroids, i-chemotherapy, i-biologics), i-HIV/AIDS, ukutshintshwa kwezitho, i-malignancies (ikakhulu i-lymphomas), ukucindezeleka okukhulu komzimba okanye kwemvakalelo, kunye nokuchaphazeleka kwe-UV. Umngcipheko uyanda kakhulu emva kweminyaka engama-50, uthelekiswa kabini kwi-decade nganye.

Umgca wesifo unamaqhosha aqhelekileyo: Iphasi yeProdromal (1–5 iintsuku) — ubuhlungu, ukushisa, ukungaboni, okanye ukungaboni kwindawo ethintela, rhoqo ngaphandle kokuba ne-rash ebonakalayo. Iphasi ye-Eruptive — ukuvela kwee-vesicles ezihlanganisiweyo kwi-base e-erythematous, eqinile kwi-unilateral kunye ne-dermatome-bound (ngokuqhelekileyo kwi-thorax njenge-belt, ngoko ke igama). Iivesicles ziba mnyama, ziqhekeka, kwaye ziqhubele phambili kwiintsuku eziyi-7–10.

Ukuphola kuthatha iiveki ezi-2–4. Ubuhlungu ngokuqhelekileyo bujolise kakhulu kwaye bunokubangela ubunzima bokulawula.

Iingxaki ezivamile nezoyikekayo kukuphazamiseka kwe-postherpetic neuralgia (PHN) — ubuhlungu obungapheliyo be-neuropathic kwi-dermatome ethintela enokuhlala iminyaka emininzi emva kokuba i-rash iphole. Umngcipheko uyanda ngokuhamba kweminyaka, ubangela ukuya kwi-30% yabo baphezulu kweminyaka engama-60. I-herpes zoster ophthalmicus (ukuchaphazeleka kwamehlo nge-ophthalmic nerve) kungabangela i-keratitis, i-uveitis, kunye nokulahleka kokubona — umngcipheko wezokwelapha. Iingxaki ezongezelelweyo ziquka i-superinfection ye-bacterial, i-zoster oticus (i-Ramsay Hunt syndrome enobuhlungu be-ubuso), i-zoster ehlakazekileyo kwi-patients abane-immunocompromised, kwaye ngokuqhelekileyo i-encephalitis okanye i-myelitis.

Ukwelashwa kwe-antiviral (i-acyclovir, i-valacyclovir, okanye i-famciclovir) kufuneka kuqale kwiiyure ezingama-72 emva kokuba i-rash iqale — ngokukhawuleza, kukhulu ukusebenza.!! I-antivirals inciphisa ixesha lesifo, yehlisa ukuphindaphinda kwe-virus, kwaye yehlisa umngcipheko we-postherpetic neuralgia. Ulawulo lobuhlungu lubalulekile: i-analgesics (i-acetaminophen, i-NSAIDs), i-opioids zokubuhlungu obukhulu, kunye nemithi yokulawula ubuhlungu be-neuropathic (i-gabapentin, i-pregabalin, i-amitriptyline) ye-postherpetic neuralgia. Ukunakekelwa kweendawo zendawo kunye nokudlulisela ngokukhawuleza kwi-ophthalmologist ye-herpes zoster ophthalmicus kubalulekile.

Ukwelashwa kukhuseleko oluphumelelayo. I-vaccine ye-recombinant adjuvanted Shingrix inika ngaphezulu kwe-90% yokhuseleko ngokuchasene ne-shingles kunye nokhuseleko olungaphezulu kwe-89% ngokuchasene ne-postherpetic neuralgia.!! Iyancomeka kubo bonke abantu abadala ukusuka kwiminyaka engama-50, kunye nabantu ukusuka kwiminyaka engama-18 abane umngcipheko ophakanyisiweyo ngenxa yokunciphisa ukhuseleko okanye iimeko ezichanekileyo.

I-vaccine ifuna iidosi ezimbini ezinikwa kwiinyanga ezi-2–6 ezahlukeneyo. Nokuba abantu abake baphila ne-shingles banokufumana i-vaccine, njengoko ukuphindaphinda kunokwenzeka.

Xa iibhola ezibuhlungu zivelisa kwelinye icala lomzimba wakho, ixesha libalulekile — ukuqala ukwelashwa kwe-antiviral ngaphakathi kweeyure eziyi-72 kuphucula kakhulu iziphumo. I-Skinscanner ingahlola ngokukhawuleza ukuba umphunga omtsha uhambelana na ne-shingles ngokusekelwe kumphunga wayo onobunzima, i-morphology ye-vesicle, kunye ne-pattern ye-dermatomal. Le mveliso yokuhlola ngokukhawuleza ingakukhuthaza ukuba ufune uncedo lwezempilo oluphuthumayo endaweni yokulinda ukuba umphunga uphumelele ngokwaso.

Ngexesha lenkqubo yokuphilisa, udokumentari lweefoto lunceda ukulandela umphuhliso ukusuka kwiibhola ezisebenzayo ukuya kwi-crusting ukuya kumphumo, lunika ulwazi olusebenzayo kumphakathi wakho wezempilo. I-Skinscanner ayifuni ukutshintsha ukuhlolwa kwezempilo okuphuthumayo — i-shingles ifuna ukwelashwa kwe-antiviral ngokukhawuleza kunye nolawulo lwezobuchule — kodwa ingakunceda ukuba uqaphele le meko ngokukhawuleza kwaye uqonde ukubaluleka kokufuna uncedo oluphuthumayo.