Herpes zoster

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Adult dermatome	Herpes zoster (shingles), disseminated	Herpes zoster (shingles) - close-up of lesion	Herpes zoster (shingles) on the arm
Herpes zoster (shingles) on the back	Herpes zoster (shingles) on the back	Herpes zoster (shingles) on the chest	Herpes zoster (shingles) on the hand
Herpes zoster (shingles) on the hand and fingers	Herpes zoster (shingles) on the neck and cheek	Shingles

Shingles

• Warning symptoms of unilateral (on one side) pain, tingling, or burning sensation limited to a specific part of the body -- pain and burning sensation may be intense
• Reddening of the skin (erythema) followed by the appearance of blisters (vesicles)
• Grouped, dense, deep, small blisters that ooze and crust

• Fever, chills
• General feeling of malaise
• Headache
• Lymph node swelling
• Vision abnormalities
• Taste abnormalities
• Drooping eyelid (ptosis)
• Loss of eye motion (ophthalmoplegia)
• Hearing loss
• Joint pain
• Genital lesions (female or male)
• Abdominal pain

Diagnosis is suspected based on the appearance of the skin lesions, and strengthened by a prior history of chickenpox or shingles. It can be confused with herpes simplex.

Tests are rarely necessary, but may include:

• Viral culture of skin lesion
• Tzanck test of skin lesion
• Complete blood count (CBC) may show elevated white blood cells, a nonspecific sign of infection
• Specific antibody (immunoglobulin) measurement demonstrates elevation of varicella antibodies

Review Date: 05/26/2006
Reviewed By: Monica Gandhi MD, MPH, Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.