Saturday, December 13

Herpes zoster symptoms

   ›      ›   Herpes zoster signs and symptoms.
Herpes zoster (shingles) is a contagious disease caused by the varicella zoster virus (VZV). Herpes zoster manifests with typical symptoms.
It is characterized by a group of small inflammatory blisters with neuralgic pain. The primary infection by varicella zoster virus manifests as varicella (smallpox) with the symptoms of widespread vesicular rash and fever.

Though the patient recovers from the chickenpox after 10-15 days, the virus is not completely eliminated from the body. The herpes zoster virus enters the nervous system and lodges itself in the cerebral ganglia or dorsal root ganglia. It attains dormancy, without causing any symptoms, lasting for a few months to several years or even a lifetime.

The varicella zoster virus, due to unknown reasons, reemerges as shingles in some individuals. About 20% of those who had chickenpox in their childhood develop zoster. Zoster blisters erupt unilaterally along the path of innervation by the affected ganglia, affecting one side of the body, most often affecting the torso, neck, arms, and legs.

diagram showing the progression of symptoms of herpes zoster infection
Herpes zoster symptoms
The above diagram shows the stages in the progression of herpes zoster symptoms.
1. Itching and burning sensation followed by inflamed patches of bumps.
2. The bumps turn into blisters.
3. The blisters fill with fluid and burst.
4. healing phase starts and the blisters crust and disappear.
5. Persisting postherpetic neuralgia for a few days to several months.
Zoster with its symptoms can develop in varicella affected children as well as adults.
shingles on neck
herpes zoster infection on neck
However individuals above fifty years of age are more prone for , probably due to their decreasing immunity. With increase in age there may be recurrent episodes. Individuals with weakened immune system, under immunosuppressive medications and newborn are under high risk.

Herpes zoster symptoms

The reactivated virus particles move along the nerve and reach the skin dermatome causing a stripe of blisters and pain. The usual sequence of events and symptom progression in herpes zoster are as follows.
  • Pain, inflammation near the region of affected nerve roots. Some individuals may develop fever.
  • Within a few hours the nerve supplying to the skin from the nerve root gets inflamed with symptoms of pain and burning sensation along its length.
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  • After two or three hours the patch of skin where the bumps and blisters will emerge becomes itchy with slight burning sensation. This area of skin is most likely to be the most affected area during the earlier varicella episode.
  • If the itchy skin is left alone without scratching bumps may appear within two or three hours. If the itchy skin is scratched, bumps will appear immediately.
  • Symptoms like severe burning pain (due to nerve damage) and itching are followed by the bumps turning into blisters.
  • Getting filled up with lymph, the blisters grow, become hard and then burst, spilling the contents.
  • The VZV virus can travel along the nerves and cause similar symptoms in the adjacent area of skin.
  • The burst blisters form crust and the crust may fall off in a week.
  • After the herpes zoster episode the symptoms like neuralgic pain along the nerve and the blister area may continue for sometime.

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1.Zostavax (Herpes Zoster Vaccine) Questions and Answers (FDA)
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1.Image source:
Author: FDA | License: public domain.
2.Image source:
Author: John Pozniak | License: CC BY-SA 3.0
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