Herpes zoster
Dermatology Infections: Viral--Clinical Symptoms and Signs




Herpes zoster

John L. Bezzant,M.D.

After having varicella, the varicella-zoster virus lodges within the *dorsa root ganglia. In about one out of four persons the virus will be reactivated along one or several dermatomes in a band-like distribution of varicella-like lesions ("dew drop on a rose petal"). Often there is a prodrome of pain or stinging or burning, and often this is felt as a very deep pain, and in hours to days later the skin eruption generally occurs. On occasion, there is no skin eruption, but there is a band-like distribution of pain, and the diagnosis can be made by obtaining acute and convalescent titers (separated by about four to six weeks) to determine if the herpes varicella antibody has risen. The eruption generally lasts about two to three weeks, and treatment within the first three days of eruption with an antiviral agent has been shown to speed healing and reduce pain, and especially to reduce the incidence of postherpetic neuralgia. The older the individual who has the eruption, the greater the chance of developing postherpetic neuralgia.

Dermatology Infections: Viral--Clinical Symptoms and Signs