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Herpes zoster - typical and atypical presentations.

Roy Rafael Dayan1, Roni Peleg1,2

  • 1a Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel.

Postgraduate Medicine
|May 26, 2017
PubMed
Summary

Varicella-zoster virus causes both chickenpox and shingles (herpes zoster). Herpes zoster reactivates dormant virus, potentially causing atypical presentations and diagnostic challenges.

Keywords:
Herpes Zosteranti-viral agentsbilateral herpes zostervaccinations for Herpes Zosterzoster sine herpete

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Area of Science:

  • Virology
  • Immunology
  • Neurology
  • Dermatology

Background:

  • Varicella-zoster virus (VZV) causes varicella (chickenpox) via acute viremia.
  • Herpes zoster (shingles) results from VZV reactivation from dormant cranial nerve or sensory root ganglia.
  • VZV reactivation spreads to innervated tissues, typically affecting a single dermatome without crossing the midline.

Purpose of the Study:

  • To discuss the epidemiology, pathophysiology, diagnosis, and management of herpes zoster.
  • To highlight typical and atypical clinical presentations of herpes zoster.
  • To emphasize the diagnostic challenges posed by atypical herpes zoster manifestations.

Main Methods:

  • Literature review and synthesis of existing research on VZV infections.
  • Analysis of epidemiological data, viral pathophysiology, and clinical manifestations.
  • Discussion of diagnostic criteria and current management strategies for herpes zoster.

Main Results:

  • Herpes zoster involves reactivation of latent VZV, leading to dermatomal rash.
  • Atypical presentations like zoster sine herpete and bilateral herpes zoster can occur.
  • Diagnosis can be challenging, requiring expertise in pain management and psychological support.

Conclusions:

  • Herpes zoster is a complex VZV reactivation disease with diverse presentations.
  • Early and accurate diagnosis is crucial for effective management and patient support.
  • Understanding atypical forms is essential for comprehensive clinical practice.