| Herpes zoster (HZ/ shingles) is a kind of common acute herpetic skin infection among adults, resulting from reactivation of Varicella- zoster virus (VZV) that has marked affect both peripheral nerve and skin. Differing from recurrent herpes simplex, herpes zoster is characterized by unilateral radicular pain (herpes zoster associated pain, ZAP), a condition where pain occuring before or accompanying with the rash. The degree of ZAP constant weight differs, and it seems to be independent of the severity of the lesion. The pain may persist for weeks, months, or even years after the skin heals. This phenomenon is known as postherpetic neuralgia (PHN).A great deal of achievement has been obtained in HZ management area. Many treatment are available, each offering variable level of efficency. Conventional options include anti-virus therapy, immunonodulatory therapy, physiotherapy, tradional Chinese therapy, etc. However, herpes zoster still presents an arduous challenge for clinicians. Current management with antiviral agents, neurophic drugs and analgesics produces reasonable results in younger patients, in whom the disease is usually milder, and is considerable against acute pain and skin rash. However, it is much less effective against PHN, which occurs more commonly in older patientis. As reported, senile herpes zoster are more relevant to PHN, whose incidence rate could mount up to 62 percent in patients over 50 years of age and rise up to 75 percent sharply in patients over 75 years of age. Predominantly, PHN could be more severely in the elderly with a devastating impact on quality of life. Once PHN has developed, current treatments offer only limited benefit and adverse effects are common. Early recognition and comprehensive treatment is well known as the key of reducing acute symptoms as well as the PHN. Depending on the differences of phases of the disease, degree of the pain and different reaction to antiviral treatment, the therapy scheme should be different in the management of senile herpes zoster. Individuation therapeutic schedule should be formulated based on different clinical situations of each patient. Generally regarded as a self-limited condition, treatment of shingles is indicated to reduce the acute symptoms of pain and malaise, to limit the spread and duration of the skin lesions and to prevent the development of post-herpetic neuralgia or other complications. However, because of restriction by corticosteriods, analgesics and NSAIDs (Nonsteroidal Antiinflammatory Drugs) in senile herpes zoster management, searching for beneficial therapies has become a matter of great concern for clinicans.For the past few years, Ultraviolet B (UVB) phototherapy has become a relatively new treatment modality commonly used for many dermatoses may be unaware of its effectiveness and applications. It was determined that, most effective wavelengths were between 280nm and 320nm, within that spectrum, a mass of biological effects can be produced after that being absorbed by epidermis as well as the papillary layer of dermis. For instance, killing viruses and bacterias in the superfial tissue, accelarating blood circulation, abirritation, relieving itching, promoting the synthesis of Vitamin D3, inhibiting hypermorphosis of epidermis cell, accelerating the regeneration of epithelium, promoting inflammation subsided and pigmental synthesis, immunoregulation, etc. Satisfied effects have been obtained in pityriasis rosea, psoriasis, alopecia areata, chronic ulcer, acne vulgaris, folliculitis and furunculosis by using UVB. Narrow-Banded Ultraviolet B (NB-UVB), an UVB light at a wavelength of (311±2) nm, can produce narrow-spectrum light in good quality, such as single colour and high stability. NB-UVB is superior to Broad-Banded Ultraviolet B (BB-UVB) with an intensified curative effect and a diminished side effect. It was generally acknowledged that, NB-UVB irradiation can release medicative energy without local skin injury (necrosis of keratinocytes), radiation biological effects have been observed such as inhibiting the activity of Langerhans cell significantly, inducing anti-inflammatory and immunosuppressive cytokines production, reducing inflammatory reaction, improving local haemal circulation, absorbing to promoting inflammation and tissue repair, especially for alleviating pain. As an acute inflammatory dermatosis manifested by severe pain, by pain, cell-mediated immunosuppressive disorders was involved in both occurrence and development of shingles. The immunity imbalances of both age-related T-lymphocytes subpopulations and Th1/ Th2 have been observed in the peripheral blood. The condition and curative effect of disease could be directly influenced by cell-mediated immunity. With little side effects and high security, NB-UVB phototherapy could be considered for using in the clinical treatment of senile herpes zoster.To evaluate the efficacy and safety of NB-UVB phototherapy in senile herpes Zoster. A hundred and twenty five volunteered patients enrolled were divided randomly into two groups. The treatment group (63 cases) received NB-UVB radiation combined with Famciclovir tablets (FCV) and neurophic drugs(Vitamin B1 tablets and Mecobalamin tablets), and the controll (62 cases) received FCV plus neurophic drug. The course of treatment for both groups was ten days, and the curative effect was evaluated by improvement of symptoms and signs. The overall cure rate in treatment group was significantly higher than that in the control (P<0.05). It also showed prominently differences in both groups among the time of pain relieving, incrustation, decrustation (P<0.01). Whereas, compared with the control, the incidence rate of post herpetic neuralgia decreased sharply in the treatment group (P<0.05). Based on what has been discussed above, we can safely draw the conclusion that the NB-UVB phototherapy could be an effective option for treating senile herpes zoster, which may especially reduce the course of treatment as well as the incidence of PHN. It is worthy popularizing in clinic.
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