I-Shingles (Herpes Zoster): Izimbangela, Izimpawu, kanye Nokwelashwa

IShingles (herpes zoster) ithuthukiswa ngokuvuselelwa kwe-varicella-zoster virus (VZV), okuyinto ehlala ibuthakathaka emigqeni ye-dorsal root ganglia kanye ne-cranial nerve ganglia impilo yonke emva kokutheleleka kwe-chickenpox. Lapho ukuvikeleka kwemizimba kwehla, le virus ingavuselelwa futhi ihambe ngama-fiber e-sensory nerve iye esikhumbeni, ibangele umphumela ojwayelekile we-rash ohlangene, ohlangothini olulodwa oluqinile. Cishe umuntu oyedwa kwabathathu abake baba ne-chickenpox uzothola iShingles phakathi kokuphila kwabo — ikakhulukazi ngemuva kweminyaka engama-50.

Ukuvuselelwa kukhuthazwa ukuhla kokuvikeleka kwemizimba. Izinto ezivamile ezibangela kanye nezingozi zifaka: ubudala obukhulayo (into enkulu yokuphila), ukuvimbela kokuvikeleka kwemizimba ngenxa yemithi (ama-corticosteroids, chemotherapy, ama-biologics), HIV/AIDS, ukuhlinzwa kwezinhliziyo, izifo ezinzima (ikakhulukazi ama-lymphomas), ingcindezi enkulu yomzimba noma yokomoya, kanye nokuhlangabezana ne-UV. Ingozi iyanda kakhulu ngemuva kweminyaka engama-50, cishe ikhulisa kabili njalo eminyakeni eyishumi.

Ukwelashwa kwalesi sifo kunezinyathelo ezijwayelekile: Isigaba se-Prodromal (1–5 izinsuku) — ubuhlungu, ukushisa, ukuvuvukala, noma ukungabi namuzwa endaweni ethintekayo, ngokuvamile ngaphandle kokuba ne-rash ebonakalayo. Isigaba se-Eruptive — ukuvela kwezigaxa ezihlanganisiwe phezu kwesizinda se-erythematous, okuhlale kuhamba ngasohlangothini olulodwa futhi kuxhumene ne-dermatome (ivame ukuba phezulu emzimbeni njengebhande, ngakho-ke igama). Izigaxa ziba mnyama, ziqhekeka, futhi ziqinisa phakathi kwezinsuku eziyi-7–10.

Ukuphola kuthatha izinsuku eziyi-2–4. Ubuhlungu ngokuvamile buyisimpawu esiyinhloko futhi bungaba buhlungu kakhulu futhi kube nzima ukukuphatha.

Inkinga evamile futhi eyethusayo kakhulu yi-postherpetic neuralgia (PHN) — ubuhlungu obuqhubekayo be-neuropathic endaweni ethintekayo engase iqhubeke izinyanga noma iminyaka ngemuva kokuba i-rash ipholile. Ingozi iyanda ngokuhamba kweminyaka, ithinta kuze kube ngu-30% kulabo abaphezulu kweminyaka engama-60. IHerpes zoster ophthalmicus (ukuhlangana kwamehlo nge-ophthalmic nerve) ingabangela i-keratitis, uveitis, kanye nokulahlekelwa kokubona — isimo esiphuthumayo sokwelashwa kwamehlo. Ezinye izinkinga zifaka ukuvuvukala okukhishwe ngamagciwane, i-zoster oticus (i-Ramsay Hunt syndrome enokukhubazeka kobuso), i-zoster ehlakazekile kubaguli abavikelekile, futhi ngezinye izikhathi i-encephalitis noma i-myelitis.

Ukwelashwa kwe-antiviral (acyclovir, valacyclovir, noma famciclovir) kufanele kuqale ngaphakathi kwezinsuku eziyi-72 zokuphuma kwesikhumba — ngokushesha, kube nomthelela omkhulu.!! Ama-antivirals anciphisa isikhathi sokugula, wehlisa ukuphindaphindwa kwe-virus, futhi yehlisa ubungozi bokuphazamiseka kwe-neuralgia ye-postherpetic. Ukuphathwa kobuhlungu kubalulekile: ama-analgesics (acetaminophen, NSAIDs), ama-opioids okuphuma kobuhlungu obukhulu, kanye nemithi yokuphathwa kobuhlungu be-neuropathic (gabapentin, pregabalin, amitriptyline) ye-postherpetic neuralgia. Ukunakekelwa kwesikhumba sendawo kanye nokudlulisela ngokushesha kumtholampilo wezokwelapha we-ophthalmologic ye-herpes zoster ophthalmicus kubalulekile.

Ukuvaccine kuyindlela yokuvikela ephumelela kakhulu. I-vaccine ye-recombinant adjuvanted Shingrix inikeza ukuvikelwa okungaphezu kwe-90% ngokumelene ne-shingles nokuvikelwa okungaphezu kwe-89% ngokumelene ne-postherpetic neuralgia.!! Iphakanyiswa kubantu abadala bonke abavela eminyakeni engu-50, kanye nabantu abavela eminyakeni engu-18 abanesikhumba esithuthukisiwe ngenxa yokwehluleka kokuvikela noma izimo eziphakeme.

I-vaccine idinga izigaba ezimbili ezinikezwa phakathi kwezinyanga ezi-2–6. Ngisho nabantu abake baba ne-shingles bangavaccineka, njengoba ukuphindaphinda kungenzeka.

Uma izikhumba ezibuhlungu zivele ohlangothini olulodwa lomzimba wakho, isikhathi sibalulekile — ukuqala ukwelashwa kwe-antiviral ngaphakathi kwezinsuku eziyi-72 kuthuthukisa kakhulu imiphumela. I-Skinscanner ingahlola ngokushesha ukuthi ingabe isikhumba esisha sihambisana ne-shingles ngokusekelwe ekusabalaleni kwayo okuhlangothini olulodwa, ubunjalo bezikhumba, kanye nephethini ye-dermatomal. Le mhlola yokuqala esheshayo ingakukhuthaza ukuthi ufune usizo lwezokwelapha ngokuphuthumayo kunokulinda ukubona ukuthi isikhumba siyaxazululwa.

Ngesikhathi sokuphola, ukuqoshwa kwezithombe kusiza ukulandela intuthuko kusuka ezikhumbeni ezisebenzayo kuya ekuphenduleni, kunikeza ulwazi oluwusizo kumhlinzeki wakho wezempilo. I-Skinscanner ayifaki esikhundleni sokuhlolwa kwezokwelapha okuphuthumayo — i-shingles idinga ukwelashwa kwe-antiviral okusheshayo nokuphathwa kochwepheshe — kodwa ingakusiza ukuthi uqaphele isimo ngokushesha futhi uqonde ukubaluleka kokufuna usizo ngokushesha.