What are the symptoms of herpes zoster?

In fact, many of our friends do not know what disease herpes zoster is, but when it comes to chickenpox, they will understand. In fact, herpes zoster is the same type as chickenpox, a viral infection, and is somewhat contagious. Patients with herpes zoster will have obvious symptoms, such as body heat, neuralgia, ulcerative keratitis, etc.

1. Typical manifestations

Before the rash occurs, there may be systemic symptoms such as mild fatigue, low fever, and poor appetite. The affected skin will feel burning or neuralgia, and there will be obvious pain sensitivity when touched, which lasts for 1 to 3 days. The rash may also occur without any prodromal symptoms. The most common sites are the areas innervated by the intercostal nerves, cervical nerves, trigeminal nerves and lumbar sacral nerves. The affected area often first develops erythema, soon followed by millet- to soybean-sized papules, which are clustered and not fused, and then quickly turn into blisters with tense and shiny blister walls, clear blister fluid, and a red halo around the periphery. The skin between clusters of blisters is normal. The lesions are arranged in a band-like manner along a peripheral nerve, mostly on one side of the body, usually not exceeding the midline. Neuralgia is one of the characteristics of this disease, which may occur before the onset of the disease or accompany skin lesions, and is often more severe in elderly patients. The course of the disease is generally 2 to 3 weeks. After the blisters dry up and the scabs fall off, temporary light red spots or pigmentation remain.

2. Special performance

(1) Herpes zoster ophthalmicus

It is caused by a virus invading the ophthalmic branch of the trigeminal nerve. It is more common in the elderly. It causes severe pain and can involve the cornea to form ulcerative keratitis.

(2) Herpes zoster oticus

It is caused by virus invasion of the facial nerve and auditory nerve, and manifests as herpes in the external auditory canal or tympanic membrane. When the geniculate ganglion is affected and the motor and sensory nerve fibers of the facial nerve are invaded at the same time, a triad of facial paralysis, ear pain, and external auditory canal herpes may occur, which is called Ramsay-Hunt syndrome.

(3) Postherpetic neuralgia

Shingles is often accompanied by neuralgia, which may occur before the rash, during the rash, and after the skin lesions have healed, but it usually disappears after the skin lesions have completely subsided or within 1 month. In a few patients, the neuralgia may last for more than 1 month, which is called postherpetic neuralgia.

(4) Other atypical herpes zoster

It is related to the difference in patients' body resistance, and can manifest as abortive type (no skin lesions, only neuralgia), incomplete type (only erythema and papules appear without blisters and then disappear), bullous type, hemorrhagic type, gangrenous type and generalized type (simultaneous involvement of more than two ganglia, resulting in skin lesions in multiple areas on the contralateral or ipsilateral side). The virus can occasionally spread through the blood to produce widespread varicella-like rash and invade organs such as the lungs and brain, which is called disseminated herpes zoster.