What is presented in a patient with herpes zoster (shingles) after a prodromal illness?

Updated: Jan 25, 2019
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

After a prodromal illness, erythematous macules and papules appear (see the image below) and progress to vesicles within 1 day. The vesicles eventually cloud, rupture, crust, and involute. Patients may experience pain and sensory loss in the distribution of the rash. Motor weakness, especially in lumbar and cervical radicular distributions, is often present but unrecognized and represents viral activity beyond the sensory root. Because the weakness often is not diagnosed accurately, the incidence and prevalence are uncertain.

Maculopapular rash due to herpes zoster in child w Maculopapular rash due to herpes zoster in child with history of leukemia. Image courtesy of Centers for Disease Control and Prevention (CDC).

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