What is herpes zoster sine herpete?

Updated: Feb 11, 2021
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Some cases of VZV reactivation result in a condition known as zoster sine herpete. Patients experience pain and weakness in a dermatomal distribution, and a tender, erythematous, unilateral patch or plaque is apparent, but there are no visible signs of cutaneous vesicles. Like typical herpes zoster (shingles), zoster sine herpete tends to be preceded by dysesthesias.

This condition presents a diagnostic dilemma; however, VZV DNA may be detected by polymerase chain reaction (PCR) assay of oropharyngeal swabs in patients with zoster peripheral facial palsy. Because such studies are not routine, the true incidence and prevalence are unknown. Furuta et al found that VZV could be demonstrated in 8-25% of patients with acute peripheral facial palsy without cutaneous vesicles. [66]

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