Materiały źródłowe

• #1 Shingles: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/shingles-treatment

  If you think you could have shingles, see a board-certified dermatologist or other health-care provider within 3 days of getting the rash. When started within 3 days, treatment can prevent possible complications, such as long-lasting nerve pain. […] Before taking the medication, its important to make sure that you have shingles. The following explains how this condition is diagnosed and treated. […] A dermatologist can often diagnose shingles by looking at the rash on your skin. […] If there is any question about whether you have shingles, your dermatologist will scrape a bit of fluid from a blister. This will be sent to a lab where a doctor will look at the fluid under a high-powered microscope. […] When you have shingles, the fluid contains the virus that causes shingles. Seeing the virus confirms that you have shingles.

• #1 Shingles (Herpes Zoster): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11036-shingles

  Shingles can be diagnosed by the way the rash is distributed on your body. The blisters of a shingles rash usually appear in a band on one side of your body. Shingles also may be diagnosed in a laboratory using scrapings or a swab of the fluid from the blisters. […] There is no cure for shingles but there are treatments for managing the symptoms. […] These drugs may ease the discomfort and make the symptoms stop sooner, particularly if you start them within 72 hours of the first sign of shingles. […] Shingles can be a very painful condition. If you think you have the symptoms of shingles, see your healthcare provider right away. Starting antiviral medications early can ease your discomfort and end symptoms earlier. […] Shingles causes a rash that is contagious and painful. The disease can have serious complications. The best thing you can do to reduce your risk is to get the shingles vaccine.

• #1 Shingles – Wikipedia

  https://en.wikipedia.org/wiki/Shingles

  Shingles is caused by the varicella zoster virus (VZV) that also causes chickenpox. […] Diagnosis is typically based on the signs and symptoms presented. […] Laboratory tests are available to diagnose shingles. The most popular test detects VZV-specific IgM antibody in blood; this appears only during chickenpox or shingles and not while the virus is dormant. […] When the rash is absent (early or late in the disease, or in the case of zoster sine herpete), shingles can be difficult to diagnose. […] Shingles can be confused with herpes simplex, dermatitis herpetiformis and impetigo, and skin reactions caused by contact dermatitis, candidiasis, certain drugs and insect bites.

• #1 Laboratory Testing for Varicella-Zoster Virus (VZV) | Chickenpox (Varicella) | CDC

  https://www.cdc.gov/chickenpox/php/laboratories/index.html

  This varicella-zoster virus (VZV) laboratory testing information applies to testing and diagnosis of primary VZV infection (varicella) and reactivation (herpes zoster). […] Polymerase chain reaction (PCR) is the most helpful laboratory test for confirming cases of varicella and herpes zoster. […] Testing is recommended to: Confirm suspected cases of varicella. […] Confirm varicella as the cause of outbreaks. […] Confirm varicella in severe cases (hospitalizations or deaths) or unusual cases. […] The preferred diagnosis method is a demonstration of VZV DNA by PCR tests from a clinical specimen, ideally scabs, vesicular fluid, or cells from the base of a lesion. […] PCR is also useful for confirming breakthrough varicella. Other methods, such as DFA and culture, are available for diagnosis but are less sensitive and specific than PCR.

• #1 How Is Shingles Diagnosed?

  https://www.healthline.com/health/how-is-shingles-diagnosed

  A doctor can usually diagnose shingles based on your symptoms. But in some cases, such as when shingles doesnt cause a rash, other testing may be necessary. […] Doctors typically diagnose shingles by a physical examination, but thats not always conclusive. Sometimes, shingles doesnt cause a rash. Other conditions might also cause physical symptoms similar to the blisters and lesions associated with shingles. […] Doctors can use other testing methods to diagnose shingles if a case is mild or has an unusual presentation. […] A polymerase chain reaction (PCR) test is the most useful test to detect the presence of VZV DNA. […] Tests for shingles are typically only necessary if the virus presents in an unusual way, which can include: mild symptoms, no rash, a widespread rash. […] Other ways to diagnose shingles exist besides a PCR test.

• #1 Laboratory Testing for Varicella-Zoster Virus (VZV) | Chickenpox (Varicella) | CDC

  https://www.cdc.gov/chickenpox/php/laboratories/index.html

  Positive serologic test for varicella-zoster immunoglobulin M (IgM) antibody when a varicella-like rash is present. […] Four-fold or greater rise in serum varicella immunoglobulin G (IgG) antibody titer by any standard serologic assay between acute and convalescent sera. […] For both unvaccinated and vaccinated people, PCR is the most reliable method for confirming a VZV infection.

• #1 Varicella-Zoster Virus Test: Key to Diagnosing Chickenpox & Shingles – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/varicella-zoster-virus-test-key-to-diagnosing-chickenpox-shingles/

  The results of a Varicella-zoster virus serology test provide valuable information about your immunity and potential infection status. The test measures two types of antibodies: IgG and IgM. Each plays a distinct role in helping your healthcare provider interpret the results accurately. […] Positive IgM: The presence of IgM antibodies may signal a recent or active varicella-zoster virus infection, such as chickenpox or shingles. Additional evaluation or follow-up testing may be necessary. […] The Varicella-zoster virus (VZV) serology test is a vital diagnostic tool for assessing immunity to chickenpox and shingles, detecting active infections, and guiding appropriate treatment decisions.

• #1 Varicella-Zoster Virus – VZV | Choose the Right Test

  https://arupconsult.com/content/varicella-zoster-virus

  If clinical features alone are not confirmatory, especially in patients who have received the recommended vaccination for shingles and in people with suppressed immune systems, laboratory testing is recommended to confirm diagnosis. […] Laboratory testing may also be appropriate to investigate outbreaks, unusual cases, or severe cases involving hospitalization or death. […] PCR testing is the most rapid and sensitive method for confirming a diagnosis of varicella or herpes zoster. As such, it is the preferred test for VZV infection. […] DFA testing is limited by the sample quality and has generally low sensitivity. If an insufficient number of infected cells is present, the results may be invalid or falsely negative. […] Serology has limited utility for laboratory diagnosis of VZV and should only be used when suitable specimens for PCR testing are not available. […] Viral culture of VZV is not recommended for initial diagnosis because its slow turnaround time may adversely impact clinical management.

• #1 Herpes Zoster (Shingles) Diagnosis and Tests – WelcomeCure

  https://www.welcomecure.com/diseases/herpes-zoster-shingles/tests-and-diagnosis

  A physician can easily diagnose shingles based on the typical clinical findings along with a previous history of chickenpox or shingles. […] Tests are very rarely performed to confirm the diagnosis; however, when necessary, the following tests can be done: […] Viral culture of the skin lesions: Culture studies for varicella-zoster virus can be done but this method is not resorted for practical purposes because the virus grows very slowly […] Tzanck test: This test helps to see the peculiar cytological changes of the HSV infection. Fluid is aspirated from an intact vesicle with a sterile syringe and the vesicle is then unroofed to make an ulcer. With the help of a sterile instrument the ulcer is then scraped and the material is put on a microscope slide, dried and fixed for staining. If multinucleate giant cells are found, the test is considered positive. By using immunofluorescent antibody reagents, the smear can differentiate between herpes viruses and non-herpes viruses; however, the smear does not help in differentiating between the herpes zoster and herpes simplex infections.

• #1 How Is Shingles Diagnosed?

  https://www.healthline.com/health/how-is-shingles-diagnosed

  A blood test can detect antibodies for the shingles virus. However, routine blood testing wont necessarily detect shingles. A healthcare professional can usually order a specific test for shingles. […] Silent shingles refers to when the condition doesnt cause a rash. Its still a result of the reactivation of VZV and can cause many of the same complications. Because theres no characteristic rash, it can be difficult to diagnose based on a physical examination alone. […] In these cases, a doctor might perform other tests, such as a PCR test.

• #1 Clinical Features of Shingles (Herpes Zoster) | Shingles (Herpes Zoster) | CDC

  https://www.cdc.gov/shingles/hcp/clinical-signs/index.html

  People with herpes zoster can have pain, itching, or tingling in the area where the rash will develop. […] The signs and symptoms of herpes zoster are usually distinctive enough to make an accurate clinical diagnosis once the rash appears. However, clinical diagnosis of herpes zoster might not be possible in the absence of a rash. […] Herpes zoster is hard to diagnose in children and younger adults, especially if the clinical presentation is mild. […] To help with diagnosis, consider if patient has a history of VZV exposure. […] PHN is the most common complication of herpes zoster. […] Approximately 10% to 18% of people with herpes zoster will have PHN. […] Herpes zoster that affects the ophthalmic division of the trigeminal nerve is called herpes zoster ophthalmicus. […] Disseminated zoster can include generalized skin eruptions where the lesions occur outside of the primary or adjacent dermatomes. […] Laboratory Testing for Varicella-Zoster Virus (VZV) […] Learn about lab testing for varicella-zoster virus (VZV), the cause of chickenpox and shingles.

• #1 Early Diagnosis of Herpes Zoster Neuralgia: A Narrative Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10289968/

  Early intervention reduces the incidence of postherpetic neuralgia (PHN). Typical shingles are easy to diagnose; however, there is no clear diagnostic method for neuralgia symptoms manifested before the onset of the rash, which can easily cause misdiagnosis. […] The early diagnosis of herpes zoster neuralgia can reduce misdiagnosis and mistreatment, and timely and effective intervention can significantly reduce the incidence of PHN. […] Early diagnosis of HZ neuralgia before eruption can facilitate timely targeted treatment, thereby reducing the incidence of PHN. […] The proteomic quantitative analysis and validation results can serve as a simple, micro, rapid, and accurate diagnostic method. […] Misdiagnosis not only increases the patients pain, medical expenses, and mental burden, but more importantly, delays the valuable time for early treatment of shingles and increases the risk of complications and PHN.

• #1 Shingles

  https://www2.hse.ie/conditions/shingles/

  For the antiviral medicine to work properly, you usually need to take it within 3 days of the rash appearing. […] It can take up to 4 weeks for the rash to heal. […] Your skin can be painful for weeks after the rash has gone, but it usually gets better over time. […] Most people recover from shingles without any problems. […] But it can cause complications, such as: post-herpetic neuralgia – this is where pain lasts for months after the shingles rash has gone; the rash gets infected – you may need antibiotics; scarring or changes in skin colour after the rash has healed; muscle weakness; eye problems – these can lead to sight loss; Ramsay Hunt syndrome – this is a rare condition where shingles causes weakness on 1 side of your face and sometimes hearing problems. […] You can reduce your risk of complications by getting treatment as soon as possible after your symptoms start. […] If you’re pregnant and get shingles, there’s no danger to your pregnancy or baby. But your GP will probably refer you to a specialist, as you may need antiviral treatment.

• #1 Postherpetic Neuralgia: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12093-postherpetic-neuralgia

  Postherpetic neuralgia (PHN) is a complication of shingles infection (also called herpes zoster). […] Postherpetic neuralgia (PHN) is usually diagnosed based on your symptoms, history of having shingles and physical exam. […] If you’ve had a recent case of shingles and have pain in the area where the shingles rash once was, you likely have PHN. […] Postherpetic neuralgia (PHN) results from damage to nerve fibers during shingles infection. […] Postherpetic neuralgia means nerve pain after herpes. […] A certain percentage of people (20%) who get shingles develop PHN. […] Although there is no cure for PHN, it can be treated. […] For most people with PHN, pain improves with time and eventually goes away. […] The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN.

• #1

  https://bpac.org.nz/bpj/2014/march/herpes.aspx

  Antiviral medicines may reduce the duration of the rash and associated pain, however, they do not reduce the risk of patients developing post-herpetic neuralgia, the most common long-term complication of shingles. […] Antiviral medicines are reported to reduce the duration of viral shedding and new lesion formation and accelerate rash healing time when given to patients in the early stages of shingles. […] Antiviral medicines have not, however, been conclusively shown to reduce the likelihood of patients with shingles developing post-herpetic neuralgia. […] Aciclovir is the recommended first-line antiviral treatment for shingles in patients who are immunocompromised. […] The role of corticosteroids in the treatment of shingles is even less clear than antiviral treatment. […] Post-herpetic neuralgia is defined as pain lasting for more than 120 days after onset of the shingles rash.

• #1

  https://bpac.org.nz/bpj/2014/march/herpes.aspx

  Post-herpetic neuralgia is the most frequent complication of shingles; estimates of prevalence range from 9 34% of patients with shingles. […] Herpes zoster ophthalmicus occurs when shingles affects the ophthalmic branch of the trigeminal nerve. […] Ramsay Hunt syndrome type II, also known as herpes zoster oticus, is a rare complication of shingles involving the geniculate ganglion of the facial nerve.

• #1 Shingles: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/shingles-treatment

  Your dermatologist will also ask about your symptoms. Shingles tends to be painful. […] One of three antiviral medications is usually prescribed: acyclovir, famciclovir, or valacyclovir. […] If you have severe pain, your dermatologist may prescribe a medication that reduces inflammation, such as a corticosteroid. […] Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.

• #1 Late diagnosis for shingles’s | Shingles | Forums

  https://patient.info/forums/discuss/late-diagnosis-for-shingles-s-564945

  I developed a spot on my arm and thought it was a spider bite about a week later it was so painful I went to the doctor and by then they were a few more spots. […] It took about three weeks to get the diagnosis from an ER doctor. […] You should have been given the Antivirals for seven days, first of all. […] This seems to be protracted with you, or you have a recurrence of shingles and need to be on a second round of Antivirals. […] It does sound like shingles. The exhaustion alone is typical. And 5 days of antivirals is less than recommended. The norm is 7 days and it can be increased to 10 for recurrent cases. […] The medications for treatment are the following: Antivirals Acyclovir 5x/day least efficacious, Valcyclovir 3x/day huge pill, Famciclovir 3x/day. […] Also, the shingles vaccine in clinical studies after breakout have proven a shorter duration and less outbreaks. […] As you are immunocompromised, it often occurs that more than one dermatome is affected. […] I plan to get the vaccine as soon as I’m able.

• #1 Chickenpox and Shingles Tests: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/chickenpox-and-shingles-tests/

  Chickenpox and shingles tests check to see if you are or have ever been infected with the varicella zoster virus (VZV). […] Testing for VZV involves checking for VZV in a blood, fluid, or tissue sample. […] Health care providers can usually diagnose chickenpox or shingles with a visual examination. But in some cases, your provider may also order a chickenpox or shingles test to confirm the diagnosis. […] You may need a chickenpox or shingles test if you are at higher risk of complications, are not immune to VZV, and/or have symptoms of infection. […] If you have symptoms and your test results show VZV antibodies or the virus itself, it’s likely you have chickenpox or shingles. Your diagnosis of either chickenpox or shingles will depend on your age and specific symptoms. […] If you are diagnosed with an infection and are in a high-risk group, your provider may prescribe antiviral medicines. Early treatment can prevent serious and painful complications. […] The best way to prevent chickenpox is to get the chickenpox vaccine. […] There is also a vaccine for shingles. It’s called Shingrix. The CDC recommends that healthy adults age 50 and older get two doses of Shingrix, separated by 2 to 6 months.

• #1 Shingles – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054

  Shingles is a viral infection that causes a painful rash. […] Shingles is caused by the varicella-zoster virus the same virus that causes chickenpox. […] Early treatment may shorten a shingles infection and lessen the chance of complications. […] Contact your health care provider as soon as possible if you suspect shingles, especially in the following situations: The pain and rash occur near an eye. If left untreated, this infection may lead to permanent eye damage. […] The shingles rash is associated with an inflammation of nerves beneath the skin. […] A person with shingles can pass the varicella-zoster virus to anyone who isn’t immune to chickenpox. […] The risk of developing shingles increases with age. […] Complications from shingles can include: Postherpetic neuralgia. […] A shingles vaccine may help prevent shingles. […] The shingles vaccine is used only as a way to prevent shingles. It’s not intended to treat people who currently have the disease.

• #2 Shingles (Herpes Zoster): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11036-shingles

  Shingles can be diagnosed by the way the rash is distributed on your body. The blisters of a shingles rash usually appear in a band on one side of your body. Shingles also may be diagnosed in a laboratory using scrapings or a swab of the fluid from the blisters. […] There is no cure for shingles but there are treatments for managing the symptoms. […] These drugs may ease the discomfort and make the symptoms stop sooner, particularly if you start them within 72 hours of the first sign of shingles. […] Shingles can be a very painful condition. If you think you have the symptoms of shingles, see your healthcare provider right away. Starting antiviral medications early can ease your discomfort and end symptoms earlier. […] Shingles causes a rash that is contagious and painful. The disease can have serious complications. The best thing you can do to reduce your risk is to get the shingles vaccine.

• #2 Getting a Shingles Diagnosis: Tests and Symptoms

  https://www.health.com/shingles-diagnosis-6836096

  Shingles, also known as herpes zoster, is a painful skin rash caused by the varicella-zoster virus (VZV). […] If you suspect you have shingles, you should visit your healthcare provider or a dermatologist (a medical doctor who specializes in skin conditions) for a diagnosis as early as possible. […] Your provider can usually make a diagnosis by examining your symptoms, such as doing a skin check. In some cases, they may recommend additional tests to confirm your condition. […] Your healthcare provider will perform a physical exam as part of a shingles diagnosis. […] Your healthcare provider will also look for one or more of the following shingles symptoms: Burning, shooting pain, Tingling, itching, or numbness of the skin, Fluid-filled blisters, Headache, Chills, Fever, Upset stomach.

• #2 Herpes Zoster Workup: Approach Considerations, Laboratory Studies, Other Studies

  https://emedicine.medscape.com/article/1132465-workup

  Diagnosis of herpes zoster (shingles) is based primarily on the history and physical findingsspecifically, the characteristic location and appearance of the skin eruption in association with localized pain. […] In most patients, confirming the diagnosis via laboratory testing usually has no utility, because most tests are time consuming, lack specificity, or are unavailable outside of research facilities. […] If the clinical diagnosis remains ambiguous, the presence of multinucleate giant cells detected via a Tzanck smear can support the diagnosis of a herpetic infection, although this test cannot distinguish between herpes simplex and herpes zoster infections. […] Laboratory differentiation of these viruses can be effectively accomplished using viral culture or polymerase chain reaction (PCR) techniques.

• #2 Is There a Test for Shingles?

  https://www.healthline.com/health/is-there-a-test-for-shingles

  A doctor can usually diagnose shingles during a physical exam. But in rare cases, you may need a test to confirm a shingles diagnosis. PCR tests are the most accurate, but there are also other options. […] A doctor can usually diagnose shingles, also called herpes zoster, by visually examining your symptoms. In some instances, though, testing may be beneficial. […] A healthcare professional may recommend testing if you are immunodeficient or at risk of complications from shingles or chickenpox. […] A doctor may also recommend a test if you have unusual symptoms. Examples include if you have no rash or a rash on an area of the body less likely to experience one. […] Clinicians can sometimes confuse shingles with other types of rashes. A test may help rule out other conditions. […] According to the Centers for Disease Control and Prevention (CDC), the polymerase chain reaction (PCR) swab test is the most useful test for shingles. PCR tests detect genetic material from a virus or other organism. PCR tests for shingles can detect DNA from VZV.

• #2 Is There a Test for Shingles?

  https://www.healthline.com/health/is-there-a-test-for-shingles

  A healthcare professional may recommend a PCR test if you have a weakened immune system and have a shingles-like rash on your body somewhere other than your trunk or face. The test is also beneficial for diagnosing shingles in people who received the chickenpox vaccine. […] Blood tests are not as accurate as PCR tests in detecting shingles. Still, a doctor may use a blood test if you have no blisters to provide a sample for a PCR test. […] Although a doctor can typically diagnose shingles through a physical exam, they may recommend a test in certain cases. […] You may need a test if you are at high risk of complications from shingles. This includes people with weakened immune systems and people who are pregnant.

• #2 Shingles | Diagnosis, Testing, Lab Methods | Herpes Zoster | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/shingles/hcp/diagnosis-testing.html

  The signs and symptoms of herpes zoster are usually distinctive enough to make an accurate clinical diagnosis once the rash has appeared. However, diagnosis of herpes zoster might not be possible in the absence of a rash (i.e., before rash or in cases of zoster without rash). […] Laboratory testing may be useful in cases with less typical clinical presentations, such as in people with suppressed immune systems who may have disseminated herpes zoster (defined as appearance of lesions outside the primary or adjacent dermatomes). […] Polymerase chain reaction (PCR) can be used to detect VZV DNA rapidly and sensitively in properly collected skin lesion specimens; however, PCR testing for VZV is not available in all settings. […] Serologic methods may also be used for laboratory diagnosis of herpes zoster, although there are challenges to interpreting the results. […] In people with compromised immune systems, even when VZV infection is diagnosed by use of laboratory methods, it may be difficult to distinguish between varicella and disseminated herpes zoster by physical examination or serological testing.

• #2 Varicella-Zoster Virus Test: Key to Diagnosing Chickenpox & Shingles – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/varicella-zoster-virus-test-key-to-diagnosing-chickenpox-shingles/

  Varicella-zoster virus serology is a diagnostic blood test that measures antibodies in your blood to determine if you have been exposed to the varicella-zoster virus, the pathogen responsible for chickenpox and shingles. This test can identify current or past infections and assess immunity. […] In cases of suspected shingles, the test can confirm a diagnosis by detecting VZV IgM antibodies. Early diagnosis is essential for starting antiviral treatment, which can reduce the severity and duration of symptoms while lowering the risk of long-term complications, such as postherpetic neuralgia (persistent nerve pain). […] A shingles blood test, such as the VZV serology test, can confirm the diagnosis by detecting a rise in IgM antibodies or a significant increase in IgG levels between two blood samples taken weeks apart. The test’s high PPV and NPV make it a reliable tool for diagnosing shingles, particularly in atypical cases where the rash is not immediately visible.

• #2 Chickenpox and Shingles Tests

  https://labtestsonline.org.uk/tests/chickenpox-and-shingles-tests

  Active cases of chickenpox and shingles, which are caused by the varicella zoster virus (VZV), are usually diagnosed from the persons symptoms and clinical presentation. […] However, testing for VZV or for the antibodies produced in response to VZV infection may be needed in certain cases. […] VZV DNA tests may be requested when person is ill with unusual (atypical) and/or severe symptoms of either primary (chickenpox) or reactivated (shingles) infection. […] Care must be taken when interpreting the results of VZV testing. […] The doctor evaluates the results in conjunction with clinical findings and the medical history of the person being tested. […] If both VZV IgG and IgM are present in a person who has symptoms, then it is likely that either they have been recently exposed to VZV for the first time and have had chickenpox or that the previous VZV infection has been reactivated and they have had shingles. […] If a test for VZV DNA is positive, then VZV is present. High levels of viral DNA tend to indicate an active infection.

• #2 Herpes Zoster Workup: Approach Considerations, Laboratory Studies, Other Studies

  https://emedicine.medscape.com/article/1132465-workup

  For herpes zoster, antigen detection from biopsy specimens can also be utilized for diagnostic confirmation. […] Because the diagnosis almost always can be made on clinical grounds, skin biopsy seldom is necessary; as a rule, it is reserved for cases that are difficult to diagnose (eg, atypical lesions). […] On rare occasions when skin biopsy is necessary, histologic findings are similar to those of herpes simplex and varicella. […] Conventional microscopy is routinely used to confirm infection by herpesviruses, though on occasion, PCR assay may then be used to demonstrate herpesvirus-specific DNA.

• #2 Herpes Zoster (Shingles) Diagnosis and Tests – WelcomeCure

  https://www.welcomecure.com/diseases/herpes-zoster-shingles/tests-and-diagnosis

  DFA or Direct Fluorescent Antibody staining of virus infected cells scraped from the base of the lesions is a rapid, specific and sensitive method for diagnosing shingles […] PCR or Polymerase Chain Reaction is a more sensitive method for detecting the virus DNA for diagnosing shingles from properly collected biopsy material […] Serological methods such as levels of IgG and IgM are useful but less specific and less frequently used.

• #2 Clinical Features of Shingles (Herpes Zoster) | Shingles (Herpes Zoster) | CDC

  https://www.cdc.gov/shingles/hcp/clinical-signs/index.html

  People with herpes zoster can have pain, itching, or tingling in the area where the rash will develop. […] The signs and symptoms of herpes zoster are usually distinctive enough to make an accurate clinical diagnosis once the rash appears. However, clinical diagnosis of herpes zoster might not be possible in the absence of a rash. […] Herpes zoster is hard to diagnose in children and younger adults, especially if the clinical presentation is mild. […] To help with diagnosis, consider if patient has a history of VZV exposure. […] PHN is the most common complication of herpes zoster. […] Approximately 10% to 18% of people with herpes zoster will have PHN. […] Herpes zoster that affects the ophthalmic division of the trigeminal nerve is called herpes zoster ophthalmicus. […] Disseminated zoster can include generalized skin eruptions where the lesions occur outside of the primary or adjacent dermatomes. […] Laboratory Testing for Varicella-Zoster Virus (VZV) […] Learn about lab testing for varicella-zoster virus (VZV), the cause of chickenpox and shingles.

• #2

  https://bpac.org.nz/bpj/2014/march/herpes.aspx

  Herpes zoster (shingles) is a self-limiting condition caused by reactivation of the Varicella zoster virus. […] Diagnosis is straightforward if the characteristic rash of shingles is present, however, patients can present with atypical features. […] Shingles can be diagnosed based on the presence of the distinctive, painful dermatomal rash. […] The differential diagnosis at this stage will vary widely and depend on the site and nature of the pain. […] Zoster sine herpete is a rare form of shingles that occurs without the rash; diagnosis is more challenging and is based on the presence of dermatomal pain and often laboratory investigation. […] Laboratory testing to investigate suspected shingles is not routinely required. […] However, there are three tests for shingles available, which may be requested if there is diagnostic uncertainty.

• #2

  https://bpac.org.nz/bpj/2014/march/herpes.aspx

  Post-herpetic neuralgia is the most frequent complication of shingles; estimates of prevalence range from 9 34% of patients with shingles. […] Herpes zoster ophthalmicus occurs when shingles affects the ophthalmic branch of the trigeminal nerve. […] Ramsay Hunt syndrome type II, also known as herpes zoster oticus, is a rare complication of shingles involving the geniculate ganglion of the facial nerve.

• #2 What can be mistaken for shingles?

  https://www.medicalnewstoday.com/articles/314047

  Shingles, also called herpes zoster, is an infection that causes a rash. […] The only way to confirm if symptoms are due to shingles is by visiting a doctor for an accurate diagnosis. […] A shingles rash tends to develop in a hallmark pattern, usually on the trunk. […] The best way to work out whether a rash is shingles is to contact a doctor. […] A doctor can perform a physical examination and order tests to confirm the diagnosis. […] Some distinguishing features of a shingles rash are that it typically only affects one side of the body. […] The symptoms and timeline of a shingles rash can help with accurately diagnosing the condition. […] It is best to contact a doctor for advice if a person develops a rash.

• #2 Signs and Symptoms of Shingles

  https://give.brighamandwomens.org/shingles/

  The clock is ticking: If you start treatment within the first 72 hours after the rash appears, antiviral medicines work better to decrease symptoms and shorten the infection time. […] Antiviral medicines slash the odds of developing postherpetic neuralgia. Antiviral medications can decrease the chance of lingering pain by up to 50%, Dr. Kopp says.

• #2 Shingles

  https://www2.hse.ie/conditions/shingles/

  For the antiviral medicine to work properly, you usually need to take it within 3 days of the rash appearing. […] It can take up to 4 weeks for the rash to heal. […] Your skin can be painful for weeks after the rash has gone, but it usually gets better over time. […] Most people recover from shingles without any problems. […] But it can cause complications, such as: post-herpetic neuralgia – this is where pain lasts for months after the shingles rash has gone; the rash gets infected – you may need antibiotics; scarring or changes in skin colour after the rash has healed; muscle weakness; eye problems – these can lead to sight loss; Ramsay Hunt syndrome – this is a rare condition where shingles causes weakness on 1 side of your face and sometimes hearing problems. […] You can reduce your risk of complications by getting treatment as soon as possible after your symptoms start. […] If you’re pregnant and get shingles, there’s no danger to your pregnancy or baby. But your GP will probably refer you to a specialist, as you may need antiviral treatment.

• #2 Study: Risk Factors Associated With Developing Ocular Complications Following Shingles Diagnosis

  https://www.pharmacytimes.com/view/study-risk-factors-associated-with-developing-ocular-complications-following-shingles-diagnosis

  Shingles, or herpes zoster, can lead to ocular complications, with keratitis being the most common issue. […] The study identified age, female gender, corticosteroid use, and stromal keratitis as risk factors for ocular complications. […] Female and older patients had a greater incidence of herpes zoster ophthalmicus and were more likely to develop ocular complications. […] The results displayed that out of 3283 individuals, ocular involvement was reported in 110 individuals with positive shingle and HZO cases. Additionally, 40 individuals developed ocular complications, with the most common complication being corneal scarring. The investigators found that age (odds ratio [OR] 1.04, 95%CI 1.0-1.1), female gender (OR 2.86, 95%CI 1.0-8.1), steroids at initial visit (4.46, 95%CI 1.4-14.6), and stromal keratitis (OR 3.45, 95% CI 1.2, 9.8) related to developing ocular complications, according to the release. […] Further findings proposed that stromal keratitis and corticosteroid use at baseline were also risk factors in developing ocular complications.

• #2 Shingles – Spine Pain Diagnostics Associates – Specially Trained Physicians to Diagnose and Manage Pain

  https://www.paindiagnostics.net/shingles.html

  Shingles usually begins with flu-like symptoms, followed by pain, tingling, and itching on a certain part of the body. Several days after the pain starts, a rash appears that could turn into fluid-filled blisters. These blisters may continue to appear for a week, and scab over about ten days later. The total time for a shingles episode is from two to four weeks, but the pain from shingles may persist after the infection has healed and the rash has disappeared. This pain is known as postherpetic neuralgia, and occurs in 10-20 percent of patients. […] Shingles is most often treated with medications, both antiviral and pain medicine. At-home remedies include taking antihistamines or using Calamine lotion to help with itching, keeping the rash clean and dry, and wearing loose clothing to help prevent the pain of touching the rash. Treatment for postherpetic neuralgia may include medication, skin patches, and for some cases, neuromodulation.

• #2 Shingles (Herpes Zoster): Symptoms, Causes, and Treatment

  https://www.webmd.com/skin-problems-and-treatments/shingles/shingles-skin

  Your doctor can diagnose shingles by asking about your medical history and your symptoms and by doing a physical exam. They can also test a small sample of fluid from your blisters. […] Antiviral drugs can help you heal faster and cut your risk of complications. Theyre most effective if you take them within 3 days of the start of a rash, so see your doctor as soon as possible. Youll probably get one of these three medications to fight the virus: Acyclovir (Zovirax), Famciclovir (Famvir), Valacyclovir (Valtrex).

• #2

  https://bpac.org.nz/bpj/2014/march/herpes.aspx

  Antiviral medicines may reduce the duration of the rash and associated pain, however, they do not reduce the risk of patients developing post-herpetic neuralgia, the most common long-term complication of shingles. […] Antiviral medicines are reported to reduce the duration of viral shedding and new lesion formation and accelerate rash healing time when given to patients in the early stages of shingles. […] Antiviral medicines have not, however, been conclusively shown to reduce the likelihood of patients with shingles developing post-herpetic neuralgia. […] Aciclovir is the recommended first-line antiviral treatment for shingles in patients who are immunocompromised. […] The role of corticosteroids in the treatment of shingles is even less clear than antiviral treatment. […] Post-herpetic neuralgia is defined as pain lasting for more than 120 days after onset of the shingles rash.

• #2 Shingles: Diagnosis & Treatment – Dermatology Surgery Center – Niceville, FL (Bluewater Bay)

  https://www.dermsurgctr.com/skin-conditions/shingles-diagnosis-treatment/

  Rash starts to clear: As the rash clears, the blisters may crack open, bleed, and scab over. For most people, the rash will clear within 2 to 4 weeks. […] An antiviral medication can reduce the amount of time that you have a shingles rash, decrease how severe the rash becomes and lower your risk of developing long-lasting nerve pain and other health problems. […] One of three antiviral medications is usually prescribedacyclovir, famciclovir, or valacyclovir. […] If you have severe pain, your dermatologist may prescribe a medication that reduces inflammation, such as a corticosteroid. […] Most people get shingles once, but its possible to get it again. […] If you have a healthy immune system, the blisters tend to clear in 7 to 10 days. The rash tends to go away completely within 2 to 4 weeks. The pain may last longer, but usually stops in 1 or 2 months. […] Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.

• #2 Postherpetic Neuralgia: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12093-postherpetic-neuralgia

  The recombinant herpes-zoster vaccine (Shingrix) is recommended to prevent shingles in adults ages 50 and older. […] If you currently have shingles, you need to wait until the shingles rash has gone away. […] PHN tends to happen in older individuals who may have other health conditions, which can complicate treatment and results.

• #2 Shingles – treatments, symptoms and causes | healthdirect

  https://www.healthdirect.gov.au/shingles

  Shingles is an infection that causes a painful, blistering rash. […] Shingles can be treated with antiviral medicine. […] When should I see my doctor? See your doctor if you are experiencing any symptoms of shingles. […] How is shingles diagnosed? To diagnose shingles, your doctor will ask you about your symptoms and examine your rash. They may test fluid from your blisters and take a blood sample from you. This can confirm if your rash is caused by shingles.

• #2 Shingles Diagnosis, Treatment and Prevention | Banner Health

  https://www.bannerhealth.com/services/infectious-disease/treatment/shingles

  Shingles (herpes zoster) is a common viral infection of the nerves. It causes a painful rash or small fluid-filled blisters on an area of skin anywhere on the body, usually on one side. Its a reactivation of the chickenpox virus. So, if youve ever had chickenpox, you can get shingles. Thats because the chickenpox virus stays inactive in your body for many years. […] Early treatment for shingles is critical, so consult a physician immediately if youre concerned you might have it. Your health care provider can usually diagnose shingles based on a report of pain on one side of the body and the appearance of the rash and blisters. […] If youre diagnosed with shingles, prescription antiviral medications such as acyclovir, valacyclovir and famciclovir can shorten the course of the illness and make symptoms less severe. Treatment is most effective if you take medication as soon as you see a rash appear. […] If you have developed a painful, blistering rash that is suspicious for shingles, visit your physician or urgent care to confirm the diagnosis and start treatment to relieve your discomfort and reduce the risk of long-term complications.

• #3 Shingles

  https://www2.hse.ie/conditions/shingles/

  Shingles is an infection that causes a painful rash. It is caused by the chickenpox (varicella zoster) virus. […] A rash usually appears a few days after the first signs. […] Your GP may prescribe medicine to help speed up your recovery and avoid longer-lasting problems. […] The medicine works best if you start taking it within 3 days of the shingles rash appearing. […] The rash appears as red blotches on your skin, on 1 side of your body only. A rash on both the left and right of your body is unlikely to be shingles. […] Shingles can also make your eyes red and sore. It can affect your sight or hearing and make it hard to move 1 side of your face. […] Your GP may prescribe antiviral tablets if: you have a weakened immune system; your pain or rash is moderate or severe; the rash is affecting other areas of your body apart from your chest, tummy and back.

• #3 Varicella-Zoster Virus – VZV | Choose the Right Test

  https://arupconsult.com/content/varicella-zoster-virus

  Varicella-zoster virus (VZV) is the etiologic agent of chickenpox (varicella) and shingles (herpes zoster). […] Because of this, clinical diagnosis has become more difficult, and laboratory confirmation of VZV is increasingly important in routine clinical practice. Laboratory tests such as polymerase chain reaction (PCR), culture, and direct fluorescent antibody (DFA) stains can identify VZV, but PCR is the preferred test in most situations due to its high specificity and quick turnaround time. […] The CDC criteria for VZV diagnosis includes positive identification of VZV by polymerase chain reaction (PCR) testing, direct fluorescent antibody (DFA) staining, culture, or serology. If VZV infection is strongly suspected due to canonical presentation, treatment should not be delayed pending laboratory results.

• #3 Herpes Zoster Workup: Approach Considerations, Laboratory Studies, Other Studies

  https://emedicine.medscape.com/article/1132465-workup

  For herpes zoster, antigen detection from biopsy specimens can also be utilized for diagnostic confirmation. […] Because the diagnosis almost always can be made on clinical grounds, skin biopsy seldom is necessary; as a rule, it is reserved for cases that are difficult to diagnose (eg, atypical lesions). […] On rare occasions when skin biopsy is necessary, histologic findings are similar to those of herpes simplex and varicella. […] Conventional microscopy is routinely used to confirm infection by herpesviruses, though on occasion, PCR assay may then be used to demonstrate herpesvirus-specific DNA.

• #3 Signs and Symptoms of Shingles

  https://give.brighamandwomens.org/shingles/

  The clock is ticking: If you start treatment within the first 72 hours after the rash appears, antiviral medicines work better to decrease symptoms and shorten the infection time. […] Antiviral medicines slash the odds of developing postherpetic neuralgia. Antiviral medications can decrease the chance of lingering pain by up to 50%, Dr. Kopp says.

• #3 Postherpetic Neuralgia: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12093-postherpetic-neuralgia

  Postherpetic neuralgia (PHN) is a complication of shingles infection (also called herpes zoster). […] Postherpetic neuralgia (PHN) is usually diagnosed based on your symptoms, history of having shingles and physical exam. […] If you’ve had a recent case of shingles and have pain in the area where the shingles rash once was, you likely have PHN. […] Postherpetic neuralgia (PHN) results from damage to nerve fibers during shingles infection. […] Postherpetic neuralgia means nerve pain after herpes. […] A certain percentage of people (20%) who get shingles develop PHN. […] Although there is no cure for PHN, it can be treated. […] For most people with PHN, pain improves with time and eventually goes away. […] The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN.

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