Clinical Features:
An
attack starts with neuralgic pain, local increased sensitivity of the
skin and high grade fever. Coetaneous lesion develops in three days
after the onset of the attack. Some times the rash may develop suddenly
without any primary symptom. The rash develops in the segmental
distribution of the affected nerve roots and it consist of typical
herpetic lesions e.g. Groups of vesicles on the inflammatory bases in
several patches, crops, each crops lasting a week. The lesions rupture
or dry up to form crusts. The crusts separate in about the week’s time,
with pigmentation and scarring. The regional glands may in large and
painful. The herpes zoster attack last for 2 to 3 weeks. The prominent
side affected is trunk (Intercostals nerves), neck (Cervical) and
face (Trigeminal distribution). Involvement of the trigeminal nerve
gives rise to lesion on the eye - herpes ophthalmic.
Most important
sequelae are the post herpetic neuralgia, most seen in middle age and
old age persons having severe attack of this disease.
Signs and Symptoms
Chicken Pox
The
typical rash of chickenpox is made up of groups of small, itchy
blisters surrounded by inflamed skin. The rash usually begins as one or
two lesions, quickly spreading throughout the body including the trunk,
scalp, face, arms, and legs. The total number of blisters varies
greatly from person to person. Over four days, each blister tends to
dry out and form a scab, which then falls off between 9 to 13 days
later.
The rash is usually preceded by:
- Fever, usually low-grade
- Fatigue
- Headache
- Flu-like symptoms
Shingles
SYMPTOMS
The
typical rash of shingles begins as redness (erythema) followed by the
appearance of blisters that cover one concentrated area of the body on
either the face, trunk, shoulders and neck, or legs (unlike the rash of
chicken pox, which is generally diffuse, meaning that it is widespread
throughout the body). These eruptions follow the path of an infected
nerve.Usually only a single nerve is involved, confining the rash to
one side and one section of the body (called a dermatome). The trunk is
the area affected in 50% to 60% of cases. The next most common site is
one side of the face, which may even involve the tongue, the eye, or
the ear.
Before
the rash appears, you will have warning symptoms of pain experienced as
a sharp, aching, piercing, tearing, or burning sensation limited to the
specific part of the body where the rash appears 1 to 5 days later.
That area may also feel itchy, numb, and unbearably sensitive to touch,
even just from your clothes touching your skin in that section.
Other symptoms that you may experience include:
- Fever (not so common)
- Malaise (feeling bad overall) and other flu-like symptoms including muscle aches
- Headache
- Swollen lymph nodes
- Visual
disturbances, drooping eyelid, loss of eye motion (if in a nerve that
affects one of your eyes or the muscles surrounding it)
- Taste abnormalities (if in a nerve that affects your tongue)
- Hearing loss (if in a nerve that affects one of your ears)