What is herpes zoster?
Herpes zoster is an acute or chronic eczematous skin disease that forms small blisters within the epidermis of the hands and feet and exhibits severe itching, fever, and vesicular rashes. It usually recurs for several months or years after the condition improves (Am J Clin Dermatol. 2010).
In the Korean Standard Classification of Diseases 7th Edition (KCD-7) disease subclassification (4th level disease) statistics, it is defined as '(L301) Dyshidrosis [Herpes zoster]' among '(L20-30) Dermatitis and Eczema' among '(L00-L-99) Diseases of the Skin and Subcutaneous Tissue' (Korea Health Insurance Review & Assessment Service).
 |
| Herpes Zoster (Am J Clin Dermatol 2010) |
The causes of hand skin diseases can be largely divided into exogenous factors (exposure to chemicals or material irritants) and endogenous factors (stress, decreased immunity, genetic factors, etc.), and dyshidrosis is classified as an endogenous factor.
The term dyshidrosis was given in 1873 to mean a disease in which blisters occur due to sweating disorders, as the blisters coincide with the areas where sweat occurs. However, later, it was revealed through pathological tissue examination that the blisters were not directly related to the sweat ducts. Therefore, the exact cause of dyshidrosis has not been identified to date.
However, it is known to worsen in the summer, occur when there is mental or physical stress, and occur frequently in people who have atopic dermatitis or have contact dermatitis to metals such as nickel or chromium, and in women aged 10-40. In addition, there are reports that aspirin, oral contraceptives, smoking, piroxicam, and immunoglobulin injections increase the occurrence of bullous eczema (JKOOD. 2011).
Symptoms of Herpes Zoster
Herpes zoster initially causes itching or discomfort in the thickest areas of the skin, such as the palms, sides of the fingers, sides of the toes, and around the toenails, and then clear small blisters appear in clusters, followed by a burning and stinging sensation, and then severe itching (Dermatology 5th edition, 2008).
It appears symmetrically on both hands or both feet, sometimes in clusters, and sometimes small blisters merge to form large blisters. At first, clear blisters of 1-2 mm are formed, but as time passes and the symptoms worsen, they become cloudy and turn red and yellow.
Unlike other areas, the hands and feet have a membrane-like structure called the stratum corneum, so when inflammation occurs, the stratum corneum fills with exudate (pus or fluid) due to inflammation, causing it to swell and take the shape of a blister. Therefore, when the inflammation of herpes zoster spreads to the back of the hand or wrist, it takes the form of typical eczematous dermatitis.
Histologically, spongiosis occurs with skin cells that grow like a sponge, along with small blisters. In the spongiosis area, shallow infiltration of lymphoid tissue cells appears around blood vessels, and in the dermis, infiltration composed of various types of inflammatory cells is observed.
 |
| Different herpes lesions in different parts of the body (Am J Clin Dermatol 2010) |
Treatment of herpes zoster
Since the cause of herpes zoster is unknown, even if you go to the hospital, they usually treat only the symptoms with symptomatic therapy.
Most cases heal naturally, but if the symptoms are severe, you can apply steroid ointment or get a prescription for oral steroid medication. However, corticosteroids, which are commonly used to treat herpes zoster, can cause various side effects when used externally or internally, and skin problems are one of the main side effects (J Kor Med Opthalmol Otolaryngol Dermatol 2016), so they may not be appropriate for chronic recurrent herpes zoster. Therefore, if the symptoms do not stop, ultraviolet light therapy is also used.
Popping blisters does not speed up or slow down the treatment of herpes. Usually, blisters recover naturally after 2-3 weeks when the inflammation improves and the epidermis falls off. However, since herpes is a disease accompanied by itching, there are cases where they burst when scratched, and if the blisters are too large, popping them to drain the exudate can help with skin regeneration and relieve pain caused by swelling. However, at home, they are often popped with needles or nail clippers that have not been properly sterilized, which can lead to secondary bacterial infections, which can be problematic. In such cases, the symptoms can spread to the wrists, ankles, and in severe cases, the neck and face, and if inflammatory substances continue to penetrate through the weakened skin gaps due to secondary infections, the itching continues and you continue to scratch, which further damages the skin, and the vicious cycle repeats. First, even if the blisters are too large or have already burst, it is appropriate to go to the hospital and get them treated.
I also had an itchy finger one day, so I was scratching it and found that starting from my right index finger, many small blisters that seemed to be deep in the skin had risen around it. The blisters didn't burst because they seemed to be deep in the skin, and since mine weren't that bad, they just subsided over time, but after they got better, it took some time for the skin to completely recover to its original state as the crust-like layer peeled off like eczema. And once they appear, they recur in the same area every few months and the area seems to be getting bigger and bigger.
 |
| Bumpy and swollen hands after the outbreak |
 |
| Areas that look like eczema after getting better |
When you get herpes, people who have severe symptoms may feel mentally distressed, but the itchiness is probably the biggest pain. At first, I didn't know what it was, so I scratched a lot, which made the swelling worse, but now, when I feel something coming up and itchy, I take a pill of Zyrtec. Zyrtec is made of cetirizine hydrochloride, and there are many cheap copies of Zyrtec, so you can ask for the cheap copy of Zyrtec. The effect is the same.
Herpes symptoms may or may not be relieved by taking antihistamines. Even if you don't get blisters when you take them, the redness goes down immediately and the itchiness goes away, so it helps me.
 |
| Before taking antihistamines |
 |
| 15 minutes after taking antihistamines |
When you really itch, it's okay to heat it slightly near the fire. I tried it and it worked pretty well.
 |
| Hot compresses help |
Herpes zoster is not contagious because it is endogenous, and physical and chemical stimuli are not direct causes, but they can be aggravating factors. According to the hand skin disease prevention guidelines suggested by the Journal of the Korean Dermatological Association, it is recommended to be careful not to touch bleach, detergent, other chemical ingredients, vegetables, fruit juice, raw meat, etc. with your hands, and to manage your hands so that they do not get wet.
댓글
댓글 쓰기