• 대한물리의학회지
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• 제2권2호
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• pp.205-212
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• 2007

Purpose : Herpes zoster is a common dermatologic disorder and is caused by reactivation of varicella zoster virus lying dormant in the ganglion of the dorsal root Methods : The aim of this study is to elucidate the clinical characteristics of herpes zoster and it's nature of pain, and is to review the method of physical therapy for pain control. Results : Herpes zoster is characterized by segmental rash, pain, and sensory symptoms, For most patients skin healing and pain resolution occur within 3-4 weeks, However, pain can continue after the rash has healed. Pain and paresthesia often the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. Motor symptomatology is less well known and is most often related to central nervous system disease, although true lower motor neuron application is also thought to exist Subclinical motor involvement is relatively more common than clinical motor weakness and is easily detected by using electromyography. Higher incidences of herpes zoster were observed in female and in the elderly. Conclusion : The nature of pain associated with herpes zoster varied from a superficial itching to server stabbing or bursting, and paresthesia occurred most frequently. Therefore, the study of herpes zoster will be more research and comprehend, and the approach of physical therapy should be need positively.

• Journal of Hospice and Palliative Care
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• 제8권1호
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• pp.52-56
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• 2005

Herpes zoster (HZ) is an acute infection of the unilateral sensory dermatome caused by varicella-zoster virus (VZV) and is characterized by vesicular eruption and unilateral pain along the involved dermatome. Although the pathogenesis of HZ is incompletely understood, it is thought that when cell-mediated immunity falls below a critical level, dormant VZV within cells of the sensory ganglia are allowed to replicate and infect the host with the resultant clinical presentation of HZ. It has been associated with immunosuppressed states, such as advanced age, leukemia, lymphoma, chemotherapy and/or radiation treatment. We present a case of a 62-year-old female patient with malignant lymphoma suffering herpes zoster ophthalmicus who did not respond to conventional treatment, and in whom the application of various nerve blocks and patient-controlled analgesia produced moderate pain relief. The patient died twenty days later due to cardiopulmonary failure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권3호
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• pp.177-183
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• 2012

Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus, an infection most commonly affecting the thoracolumbar trunk. Herpes Zoster Infection (HZI) may affect the cranial nerves, most frequently the trigeminal. HZI of the trigeminal nerve distribution network manifests as multiple, painful vesicular eruptions of the skin and mucosa which are innervated by the infected nerves. Oral vesicles usually appear after the skin manifestations. The vesicles rupture and coalesce, leaving mucosal erosions without subsequent scarring in most cases. The worst complication of HZI is post-herpetic neuralgia; other complications include facial scarring, motor nerve palsy and optic neuropathy. Osteonecrosis with spontaneous exfoliation of the teeth is an uncommon complication associated with HZI of the trigeminal nerve. We report several cases of osteomyelitis appearing on the mandible, caused by HZI, and triggering osteonecrosis or spontaneous tooth exfoliation.

• Journal of Oral Medicine and Pain
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• 제46권1호
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• pp.9-13
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• 2021

Herpes zoster is caused by reactivation and multiplication of a latent varicella-zoster virus infection. Reactivation can frequently occur in older adults and immunosuppressed individuals. It is hypothesized that this is related to an aging society and a corresponding increase in the number of people with underlying chronic diseases, such as cancer and diabetes, that lower immunity. Clinically, the patient complains of pain, and a vesicular rash presents on one side of the face up to the midline in the dermatomes associated with the affected ganglion. Herpes zoster of the oral mucosa is rare. When oral lesions do occur, they are most often concurrent with pathognomonic unilateral linear vesicular skin lesions, facilitating both clinical diagnosis and management of the condition. Cases limited to the oral mucous membrane alone are most unusual. Treatment includes antiviral agents and analgesics for pain control. Antivirals should be administered within 72 hours of onset. Early diagnosis and treatment are important to avoid complications, such as postherpetic neuralgia. The present case report describes the adequate management of a patient diagnosed with shingles which affected the right side of the face and oral cavity. In addition, a literature review is presented.

• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.380-384
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• 2009

급성 횡단성 척수염은 갑자기 발생하는 하지의 진행성 쇠약과 감각 장애가 특징이며, 대부분의 환자가 선행하는 바이러스 감염 증상의 병력을 가진다. 원인이 되는 선행 바이러스는 Epstein-Barr 바이러스, 헤르페스, 인플루엔자, 풍진, 볼거리, 수두 바이러스 등이 있다. 대개 발병 1주 내에 회복을 보이기 시작하지만 수 주 또는 수 개월 동안 지속되는 경우도 있으며, 방광 기능 장애와 하지 쇠약감 등의 후유증이 남을 수 있는 소아에서 비교적 발병이 드문 질환이다. 저자들은 수두를 앓고 난 뒤 전신 마비를 주소로 내원하여 척수 자기공명영상에서 횡단성 척수염을 진단받고, 치료 후 경미한 방광 기능 장애만 남고 거의 완전한 회복을 보인 1예를 경험하였기에 보고하는 바이다.

• Archives of Pharmacal Research
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• 제23권4호
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• pp.418-423
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• 2000

Oka strain VR-795 (Varicella Zoster Virus, VZV) of American Type Culture Collection (ATCC) has been used for chickenpox vaccine production. In order to use this strain for vaccine production, the strain must be identified and its stability must be confirmed. The identification of the Oka strain has been confirmed using Restriction Fragment Length Polymorphism (RFLP) and DNA sequence analysis of glycoprotein-II (gp-II). The amino acid sequences of Oka deduced from the DNA sequence of gp-II have changed at three amino acids against Ellen and at one amino acid against Webster. To prove the stability of the Oka strain during the passage, RFLP and DNA sequence analyses were also used with 11, 15 and 23 times of virus passage. We found that the Oka strain was stable at passages of up to 23 times, based on the RFLP and DNA sequence analyses. The confirmed Oka strain was renamed as BR-Oka for the purposes of chickenpox vaccine production.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.337-340
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• 2008

Purpose: Herpes zoster is a common dermatologic disease characterized by unilateral pain and vesicular lesions over the unilateral sensory dermatomes being caused by the reactivation of Varicella zoster virus and its incidence seems to be increasing recently. In case of involving the ganglion of the fifth cranial nerve(trigeminal nerve), it can descend down the affected nerve into skin, then producing an eruption in the dermatome. Among the patients, about 40 - 50% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, pharyngitis but rare facial trauma. Methods: Retrospective study was done for 3 cases of Herpes zoster from May 2000 to May 2007, which had been treated with acyclovir and steroid. Results: The clinical course was uneventful. Follow-up length was about 3 months. After treatment, the patients became stable and there was no complications. Conclusion: Herpes zoster was commonly associated with systemic disorders and the treatment duration was prolonged in associated diseases. But herpes zoster occurring specifically at the site of previously traumatized facial skin has not yet been reported. We experienced the treatment of herpes zoster developing within recent operative facial scar and three cases are presented with the review of literatures. Finally, facial trauma might be a risk factor for herpes zoster in traumatized patients.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.803-805
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• 2009

Purpose: Many conditions can mimic the presentation of burns. Herpes zoster is one of them. The characteristic features of herpes zoster such as vesicles, pustular lesions and crusts can also be found in burns. Herpes zoster ophthalmicus is a disease caused by recurrent infection of varicella - zoster virus in the ophthalmic division of the trigeminal nerve. This virus frequently affects nasociliary branch and serious ocular complications can occur. Thus, early diagnosis and proper treatment of this disease is important to prevent further ocular manifestations. We report a man who sustained minor facial burn injury that was complicated with herpes zoster ophthalmicus. Methods: A 66 - year - old man visited emergency room with multiple whitish vesicles with serous discharge on right forehead, right medial canthal area and nose. At first he was thought to have a secondary infection of facial burn injury. The vesicles on his face began to form crusts on the next day. Since his skin lesion was located on the ophthalmic division of trigeminal nerve, we also suspected herpes zoster ophthalmicus. He was referred to dermatologist and ophthalmologist. Results: We used antiviral agent (Acyclovir) and NSAIDs for treatment. The patient had no ocular complications. His skin lesion was almost healed after 1 month and remained scars. We treated a patient with minor facial burn complicated with herpes zoster ophthalmicus with antiviral agent. Conclusion: In this work, we describe a case of old patient with herpetic infection and emphasize the need for careful examination to diagnose accurately.

• Pediatric Infection and Vaccine
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• 제9권1호
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• pp.61-66
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• 2002

목 적 : 수두는 Varicella zoster virus(VZV)의 일차 감염에 의한 전염병으로, 전염률이 80~90%에 이르는데 예방법은 접촉 후 72시간 이내에 zoster immune globulin(ZIG)이나 백신을 투여하는 것이나 전염시기가 발진이 발생하기 24~48시간 전부터이므로 효과적인 예방이 매우 어렵다. 본 연구는 가족 내 수두 환자와 접촉한 지 72시간 이상 경과된 경우의 예방법으로 보다 실질적이라 생각되는 ACV 투여가 수두 예방에 과연 효과적인지를 확인하기 위하여 본 연구를 시도하였다. 방 법 : 1996년 3월부터 1997년 7월까지 가톨릭대학교 성빈센트병원 소아과 외래에서 수두로 진단받았으나 수두의 병력이 없으면서 백신을 접종 받지 않았던 소아를 대상으로 가족 내의 환자 발생 9일째부터 치료군은 Acyclovir 40 mg/kg/일 4회 분복으로 5일간 투여하였고 대조군은 아무런 약제도 투여하지 않았다. 임상적인 진단은 전형적인 발진의 발생으로 하여 관찰되는 발진의 숫자를 발진이 없는 경우부터 6단계로 구분하였다. 혈청학적 진단기준은 VZV IgM이 양성이거나, VZV IgG가 양전된 경우로 하여 치료군에 한하여 약제 투여가 끝난 1주일과 4주일이 경과된 시점에 VZV에 대한 항체 검사를 시행하였다. 결 과 : 치료군 20명 중 검체 채취가 완전하고 과거의 불현성 감염으로 판단되는 3명을 제외한 총 12명만을 대조군 20명과 비교하였다. 감염원, 치료군 및 대조군의 평균 연령은 각각 51.4개월, 28.5개월 및 31개월로 감염원이 치료군 및 대조군의 연령에 비하여 의미있게 높았다(P<0.05). 혈청학적 진단으로 VZV 감염이 증명된 경우는 치료군 12명 중 9명(75%)으로 ACV 투여 후의 첫번째 및 두번째 검체에서 IgM이 양성인 경우는 각각 6명과 3명이었다. 이 중 두번째 검체에서 양전된 경우가 2명이었다. 따라서 VZV IgM으로 감염이 증명된 경우가 8명이었고 첫번째에선 IgM, IgG 모두 음성이었으나 두번째 검체에서 IgG가 양성으로 전환되어 증명된 경우가 1명이었다. 치료군 12명 중 발열은 모두 없었으며 3명(25%) 에서만 2단계의 경한 발진을 보였으나 대조군 20명 중 발열은 15명(75%), 3단계 이상의 발진이 17명(85%)으로 치료군과 통계적으로 의미있는 차이를 보였다. 또한 대조군 20명에서는 모두 수포가 관찰되었으나 치료군에서는 3명만 발진이 관찰되었고 그 중 수포가 발생한 경우는 1명뿐이었다. 결 론 : ACV 치료군에서는 피부 발진의 빈도 및 세기가 낮아 수두의 임상 증상이 나타나기 7일 전에 ACV를 가족 내 접촉자에게 투여했을 때 감염을 예방할 수 있는 것으로 확인되었다. 약제의 투여 시기는 바이러스혈증이 존재하는 발진의 발생 5일 전부터 1일 후까지로 바이러스의 증식을 억제할 수 있으므로 노출 9일째부터 ACV를 투여한 군에서 효과가 있을 것으로 추정된다. 약제 투여 후의 임상적 효과와 VZV에 대한 영구적 면역 획득 여부에 대해선 아직 잘 밝혀지지 않은 상태로 VZV 감염의 예방요법으로서 ACV의 일반적 적용을 위해서는 다방면의 연구가 지속되어져야 하겠다.

• The Korean Journal of Pain
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• 제21권3호
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• pp.237-240
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• 2008

Ramsay Hunt syndrome is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction, and is attributed to varicella zoster virus infection in the geniculate ganglion. Ramsay Hunt syndrome accounts for about 10% cases of facial palsy. We report a 46-year-old healthy man developed left side skin vesicles on the face with severe pain. We thought of the trigeminal herpes zoster. He was treated with intravenous acyclovir, and stellate ganglion block daily. Four days later, brain magnetic resonance imaging revealed small areas of enhancement in the seventh cranial nerve and eighth cranial nerve, not in the fifth cranial nerve. Eight days later, the left facial palsy was come. We confirmed him as Ramsay Hunt syndrome. We started steroid therapy immediately. He recovered completely a month later. The patient was improved through the early antiviral therapy, steroid medication and stellate ganglion block.