Caused by reactivation of a primary varicella-zoster virus (VZV) infection because of a decline in the virus-specific cell-mediated immunity.
Usually presents with pain described as burning or stabbing followed by a vesicular rash in the affected dermatome.
The location of symptoms depends on the location of 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 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
BMJ Case Reports 2009 [doi:10.1136/bcr.07.2008.0533] Copyright © 2009 by the BMJ Publishing Group Ltd.
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