What are the signs and symptoms of herpes zoster (shingles)?

Updated: Feb 11, 2021
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Symptoms typically include prodromal sensory phenomena along 1 or more skin dermatomes lasting 1-10 days (average, 48 hours), which usually are noted as pain or, less commonly, itching or paresthesias. [3] Prodromal pain typically is described as muscle or toothachelike in origin but may simulate headache, iritis, pleurisy, brachial neuritis, cardiac pain, appendicitis or other intra-abdominal disease, or sciatica. This simulation can result in incorrect tentative diagnoses; however, the dermatomal distribution usually helps clarify the diagnosis.

The prodromal interval of pain prior to onset of cutaneous findings has been believed to represent spread of varicella-zoster virus (VZV) particles along sensory nerves; however, approximately 10% of patients report the simultaneous onset of pain and rash.

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