From the Guidelines
The signs and symptoms of herpes zoster, also known as shingles, typically include a painful rash characterized by a vesicular eruption, usually unilateral and confined to a single dermatome [ 1 ]. Patients may also experience prodromal symptoms such as itching, burning, or tingling in the affected area, often accompanied by fever, headache, and fatigue.
Key Characteristics of Herpes Zoster
- The rash is typically unilateral and confined to a single dermatome [ 1 ]
- Prodromal symptoms such as itching, burning, or tingling in the affected area may occur 24-72 hours before the rash appears [ 1 ]
- The rash is characterized by erythematous macules that rapidly evolve to papules and then to vesicles, which may coalesce and form bullae [ 1 ]
- The disease duration is approximately 2 weeks in healthy hosts, but may be longer in immunocompromised hosts [ 1 ]
Complications of Herpes Zoster
- Postherpetic neuralgia (PHN): a common complication, particularly in older persons, characterized by persistent pain weeks to months after resolution of the rash [ 1 ]
- Herpes ophthalmicus: a severe manifestation that can lead to blindness [ 1 ]
- Dissemination: a life-threatening complication that can involve generalized skin eruptions, and central nervous system, pulmonary, hepatic, and pancreatic complications, typically restricted to immunocompromised persons [ 1 ]
From the Research
Signs and Symptoms of Herpes Zoster (Shingles)
The signs and symptoms of Herpes Zoster (Shingles) include:
- Malaise, headache, low-grade fever, and abnormal skin sensations for two to three days before the classic maculopapular rash appears 2
- A unilateral, maculopapular rash that is usually confined to a single dermatome and typically progresses to clear vesicles that become cloudy and crust over in seven to 10 days 2, 3
- Burning pain that typically precedes the rash by several days and can persist for several months after the rash resolves 3
- Pain in a dermatomal distribution that can be highly debilitating 3, 4
- Prodromal symptoms such as pain, itching, and malaise 4
- Atypical signs such as intermittent throbbing pain in more than three dermatomes, including the frontal, orbital, temporal, and occipital/nuchal areas 5
- Symptoms of cystitis, penile numbness, and acute vestibular failure in rare cases 6
Complications of Herpes Zoster (Shingles)
Complications of Herpes Zoster (Shingles) include:
- Postherpetic neuralgia (PHN), which is defined as significant pain or dysaesthesia present ≥ 3 months after HZ 3, 4
- Ocular involvement, which can lead to rare but serious complications such as sight-threatening complications of ophthalmic HZ 3, 4
- Motor deficit, which is common, and severe and long-lasting paresis may rarely accompany HZ 4
- Stroke, encephalitis, and myelitis, which are relatively rare but severe complications 4