Herpes zoster infection

Herpes zoster (also known as shingles) typically presents with pain described as burning or stabbing, followed by a vesicular rash in the affected dermatome; location of symptoms depends on the affected nerve.

Diagnosis is primarily based on the typical clinical symptoms, such as dermatomal pain and eruption of grouped vesicles in the same dermatome. Confirmation can be done using polymerase chain reaction (PCR) methods.

Treatment is primarily to reduce pain using analgesics and viral replication using antiviral medicine such as aciclovir.

Antiviral therapy may reduce the severity of postherpetic neuralgia. Early antiviral therapy is particularly important in ophthalmic zoster and zoster in the immunocompromised.

Herpes zoster (HZ), caused by reactivation of varicella-zoster virus (VZV) that was acquired during a primary varicella infection, is characterised by dermatomal pain and papular rash.[1]Gnann JW Jr, Whitley RJ. Herpes zoster. N Engl J Med. 2002 Aug 1;347(5):340-6. http://www.ncbi.nlm.nih.gov/pubmed/12151472?tool=bestpractice.com The pain typically precedes the rash by several days and can persist for several months after the rash resolves. The rash usually presents in a single dermatome and typically resolves within 4 to 5 weeks. A common complication is postherpetic pain.[2]Roxas M. Herpes zoster and postherpetic neuralgia: diagnosis and therapeutic considerations. Altern Med Rev. 2006 Jun;11(2):102-13. http://www.ncbi.nlm.nih.gov/pubmed/16813460?tool=bestpractice.com