Turkey, shingles after the new crown vaccine injection, botulinum toxin can relieve neuralgia

The terrible aspect of the new coronavirus is that, in addition to being unfriendly to people over 70 years old and people with combined medical conditions such as lung disease and obesity, its countless clinical manifestations have surprised the medical community

There are three main foreign vaccines, namely the modern vaccine and Pfizer approved by the FDA , and the newly approved Johnson & Johnson vaccine.

On February 5, 2021, the Las Vegas Dermatology Clinic discovered the first case of varicella-zoster virus infection related to the COVID-19 vaccine

Let's look at a few of them

Case number one

A 77-year-old male patient with a history of psoriasis, methotrexate, Crohn’s disease, and treated aspergilloma developed severe pain in the right middle abdomen, right side and right middle back area , Unilateral skin herpes outbreaks

Case two

A 65-year-old man with a history of herpes zoster 35 years before the onset of symptoms, long-term high blood pressure, and received counseling due to pain, erythema, and clustered skin rashes

Botulinum toxin injection relieves post-herpetic neuralgia

Post-herpetic neuralgia to drug treatment based on national experts consensus recommended treatment of first-line drugs, including calcium channel modulators (pregabalin and gabapentin), tricyclic antidepressants (amitriptyline) and more than 5% profit Caine patches, second-line drugs include opioids and tramadol

The injection scheme is as follows : Generally, the drug concentration is 2.

Generally, it takes effect 7 days after the injection, which can significantly reduce pain and reduce the use of opioids, and the effect can be maintained for 3 to 4 months

The incidence of adverse reactions to neuralgia after botulinum toxin treatment of shingles is extremely low

The terrible aspect of the new coronavirus is that, in addition to being unfriendly to people over 70 years old and people with combined medical conditions such as lung disease and obesity, its countless clinical manifestations have surprised the medical community

There are three main foreign vaccines, namely the modern vaccine and Pfizer approved by the FDA , and the newly approved Johnson & Johnson vaccine.

On February 5, 2021, the Las Vegas Dermatology Clinic discovered the first case of varicella-zoster virus infection related to the COVID-19 vaccine

A 77-year-old male patient with a history of psoriasis, methotrexate, Crohn’s disease, and treated aspergilloma developed severe pain in the right middle abdomen, right side and right middle back area , Unilateral skin herpes outbreaks

Case two

A 65-year-old man with a history of herpes zoster 35 years before the onset of symptoms, long-term high blood pressure, and received counseling due to pain, erythema, and clustered skin rashes
.
Symptoms started after he was injected with Pfizer vaccine for the second time, he developed itching 14 days after vaccination, and then developed chest pain and back pain intensified 3 days after itching
.
The patient was diagnosed with herpes zoster virus infection, and then received a course of valacyclovir treatment for the virus, oral gabapentin and topical 4% lidocaine for pain
.

Botulinum toxin injection relieves post-herpetic neuralgia

Post-herpetic neuralgia to drug treatment based on national experts consensus recommended treatment of first-line drugs, including calcium channel modulators (pregabalin and gabapentin), tricyclic antidepressants (amitriptyline) and more than 5% profit Caine patches, second-line drugs include opioids and tramadol
.
Non-drug treatments mainly include nerve block, selective nerve damage, intrathecal drug infusion therapy, and neuromodulation therapy
.
With the deepening of research, the local injection of botulinum toxin in the treatment of post-herpetic neuralgia is safe, effective and low in adverse reactions, attracting more and more attention
.

The injection scheme is as follows : Generally, the drug concentration is 2.
5～5U/0.
1mL
.
According to the skin lesions and paresthesia, multiple subcutaneous injections are selected for the affected areas.
There are reports in the literature that intradermal injections are given, but the duration of the effect is relatively short
.
The injection dose is 2.
5 to 5.
0 U per point, and the skin surface is separated by 1 to 2 cm.
Treatment is performed after the skin lesion has healed (see the figure below)
.

Generally, it takes effect 7 days after the injection, which can significantly reduce pain and reduce the use of opioids, and the effect can be maintained for 3 to 4 months
.

The incidence of adverse reactions to neuralgia after botulinum toxin treatment of shingles is extremely low
.
Local muscle stiffness, edema at the injection site, congestion, etc.
may occur; it is generally reversible and usually relieves itself within 1-3 weeks without special treatment
.
For long-term oral anticoagulation and antiplatelet aggregation drugs, it is recommended to stop the injection for a short time; for those with loose skin tissues, it is necessary to extend the compression time after injection to help avoid bleeding and ecchymosis
.
For patients with local injection therapy for post-herpes zoster neuralgia, care should be taken to avoid deep puncture to avoid damage to the chest cavity
.