BMJ Best Practice Podcast

Herpes zoster infection

10 snips
Jul 26, 2022
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INSIGHT

Zoster Is Viral Reactivation In One Dermatome

  • Herpes zoster is reactivation of varicella zoster virus that remains dormant in nerves after chickenpox infection.
  • It usually appears in a single dermatome rather than diffusely across the body.
ADVICE

Diagnose Clinically; Reserve Tests For Unclear Cases

  • Make a clinical diagnosis by looking for clustered vesicles on a red base limited to one side and one dermatome.
  • Send lesion fluid for PCR or DFA only when the presentation is unclear between zoster and herpes simplex.
ADVICE

Check Skin In Any New Localized Pain

  • Always examine the skin when assessing unexplained localized pain because zoster pain often precedes the rash.
  • Reassess patients with unresolved chest or back pain in case a rash appears later.
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