Herpes zoster infection - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

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

Severe herpes zoster in an immunocompromised patient showing multiple groupled vesicles, a few pustules, and extensive blackish adherent crusts with underlying erosions noted

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Severe herpes zoster in an immunocompromised patient involving dermatomes T1 and T2
Severe herpes zoster in an immunocompromised patient involving dermatomes T1 and T2
Severe herpes zoster in an immunocompromised patient showing multiple groupled vesicles, a few pustules, and extensive blackish adherent crusts with underlying erosions noted

Citations

Key Articles

Dworkin RH, Johnson RW, Breuer J, et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007 Jan 1;44 Suppl 1:S1-26.[Abstract][Full Text]
National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: varicella-zoster virus. 2022 [internet publication].[Full Text]
Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines. MMWR Morb Mortal Wkly Rep. 2018 Jan 26;67(3):103-8.[Abstract][Full Text]
Centers for Disease Control and Prevention. Adult immunization schedule. Recommendations for ages 19 years or older, United States, 2024. Nov 2023 [internet publication].[Full Text]
Severson EA, Baratz KH, Hodge DO, et al. Herpes zoster ophthalmicus in Olmsted County, Minnesota: have systemic antivirals made a difference? Arch Ophthalmol. 2003 Mar;121(3):386-90.[Abstract][Full Text]

Referenced Articles

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