Herpes zoster physical examination: Difference between revisions

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{{Herpes zoster}}
{{Herpes zoster}}
{{CMG}}; L. Katie Morrison, MD; '''Associate Editor(s)-In-Chief:''' {{CZ}}; {{JH}}.
{{CMG}}; L. Katie Morrison, MD; '''Associate Editor(s)-In-Chief:''' {{CZ}}; {{JH}}.
Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.


== Physical Examination ==
== Physical Examination ==
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The rash develops into clusters of clear vesicles. New vesicles continue to form over three to five days and progressively dry and crust over. They usually heal in two to four weeks. There may be permanent pigmentation changes and scarring on the skin.
The rash develops into clusters of clear vesicles. New vesicles continue to form over three to five days and progressively dry and crust over. They usually heal in two to four weeks. There may be permanent pigmentation changes and scarring on the skin.
<div align="left">
 
<gallery heights="175" widths="175">
===Gallery===
 
=====Skin=====
 
(Images shown below courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
 
<gallery>
Image:Skin zoster buttocks1.jpg|Herpes Zoster: Coalesced [[vesicle]]s resulting from reactivation of HZV [[infection]].
Image:Skin zoster buttocks2.jpg|Herpes Zoster: [[dermatome|Dermatomally]] distributed vesicles, many of which have coalesced, in patient with HZV infection. 
Image:Skin zoster buttocks4.jpg|Herpes Zoster: [[dermatome|Dermatomally]] distributed vesicles in patient with HZV infection. 
Image:Skin_zoster_buttocks3.jpg|Herpes Zoster: [[dermatome|Dermatomally]] distributed vesicles, many of which have coalesced, in patient with HZV infection.
Image:Herpes zoster4.jpg|Shingles on waist
 
Image:Herpes zoster1.jpg|[[dermatome|Dermatomal]] involvement of [[rash]]
Image:Herpes zoster1.jpg|[[dermatome|Dermatomal]] involvement of [[rash]]
Image:Herpes zoster2.jpg|[[dermatome|Dermatomal]] involvement of skin rash
Image:Herpes zoster2.jpg|[[dermatome|Dermatomal]] involvement of skin rash
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Image:varicella zoster.jpg|Varicella zoster
Image:varicella zoster.jpg|Varicella zoster
</gallery>
</gallery>
</div>


===Gallery===
<gallery>
Image:skin_herpes_zoster.jpg|Herpes Zoster. <br> (Courtesy of Josh Fierer, M.D. and Charlie Goldberg, M.D.)
Image:c3zoster.jpg|Herpes Zoster C3 Distribution: [[dermatome|Dermatomally]] distributed vesicles, many of which have coalesced, in patient with HZV infection.
Image:c3zoster2.jpg|Herpes Zoster C3 Distribution: [[dermatome|Dermatomally]] distributed vesicles, many of which have coalesced, in patient with HZV infection.
Image:Herpes zoster 5.jpg|Shingles on face
Image:Herpes zoster3.jpg|Shingles on face
</gallery>
 
<gallery>
Image:Herpes zoster 6.jpg|Child with shingles who had a history of [[leukemia]]
Image:Herpes zoster 7.jpg|[[Plantar]] foot [[rash]] caused by herpes zoster
Image:Herpes zoster 8.jpg|[[Vesicle|Vesicular]] [[lesion]]s of Herpes zoster
Image:Herpes zoster9.jpg|The [[pathological|pathologic]] changes seen on the surface of the right unilateral side of this elderly male patient’s tongue and chin, represent a herpes outbreak due to the [[Varicella zoster virus]] (VZV) pathogen.
Image:Herpes zoster 10.jpg|The [[pustule|pustulo-]][[vesicle|vesicular]] [[rash]] on this African-American woman’s face, represents a herpes [[outbreak]] due to the [[Varicella zoster virus]] (VZV) pathogen.
</gallery>
 
<gallery>
Image:Herpes zoster 11.jpg|This 1968 image depicted a number of varicella, or [[chickenpox]] [[lesion]]s on a patient’s back, which were displaying the characteristic “cropping” distribution, or manifesting themselves in clusters, each in a different developmental stage.
Image:Herpes zoster 12.jpg|This patient presented with what was differentially diagnosed as a herpes zoster [[outbreak]] in order to rule out [[syphilis]].
Image:Herpes zoster 13.jpg|This skin disorder was found to be herpes zoster, not [[Syphilis|syphilitic]] in nature as was initially suspected.
Image:Herpes zoster 14.jpg|These skin [[lesion]]s on the forehead of an elderly woman are due to the herpes zoster [[virus]] on the 21st day of the illness.
Image:Herpes zoster 15.JPG|A case of shingles that demonstrates the typical [[dermatome|dermatomal]] distribution, in this case C8/T1
</gallery>


====Head====
=====Head=====


<gallery>
<gallery>
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</gallery>
</gallery>


====Trunk====
=====Trunk=====


<gallery>
<gallery>
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</gallery>
</gallery>


====Extremities====
=====Extremities=====


<gallery>
<gallery>
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</gallery>
</gallery>


====Neck====
=====Neck=====


<gallery>
<gallery>
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</gallery>
</gallery>


====Genitourinary System====
=====Genitourinary System=====


<gallery>
<gallery>
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</gallery>
</gallery>


====Skin====
=====Skin=====


(Images shown below courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
(Images shown below courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
Line 100: Line 131:
Image:Skin_zoster_buttocks3.jpg|Herpes Zoster: [[dermatome|Dermatomally]] distributed vesicles, many of which have coalesced, in patient with HZV infection.
Image:Skin_zoster_buttocks3.jpg|Herpes Zoster: [[dermatome|Dermatomally]] distributed vesicles, many of which have coalesced, in patient with HZV infection.
Image:Herpes zoster4.jpg|Shingles on waist
Image:Herpes zoster4.jpg|Shingles on waist
</gallery>
 
Image:Herpes zoster1.jpg|[[dermatome|Dermatomal]] involvement of [[rash]]
Image:Herpes zoster2.jpg|[[dermatome|Dermatomal]] involvement of skin rash
Image:Herpes zoster chest.jpg|Herpes zoster on the chest
Image:Varicella child-ab.jpg
Image:varicella zoster.jpg|Varicella zoster</gallery>
</div>
</div>


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</gallery>
</gallery>
</div>
</div>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 12:19, 8 October 2014

Herpes zoster Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Herpes zoster from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Herpes Zoster
Congenital Varicella Syndrome

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Herpes zoster physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Herpes zoster physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Herpes zoster physical examination

CDC on Herpes zoster physical examination

Herpes zoster physical examination in the news

Blogs on Herpes zoster physical examination

Directions to Hospitals Treating Herpes zoster

Risk calculators and risk factors for Herpes zoster physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; L. Katie Morrison, MD; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Jesus Rosario Hernandez, M.D. [3].

Physical Examination

People with herpes zoster most commonly have a rash in one or two adjacent dermatomes (localized zoster). The rash most commonly appears on the trunk along a thoracic dermatome. The rash does not usually cross the body’s midline. However, approximately 20% of people have rash that overlaps adjacent dermatomes. Less commonly, the rash can be more widespread and affect three or more dermatomes. This condition is called disseminated zoster. This generally occurs only in people with compromised immune systems. Disseminated zoster can be difficult to distinguish from varicella.

The rash develops into clusters of clear vesicles. New vesicles continue to form over three to five days and progressively dry and crust over. They usually heal in two to four weeks. There may be permanent pigmentation changes and scarring on the skin.

Gallery

Skin

(Images shown below courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)

  • Herpes Zoster: Coalesced vesicles resulting from reactivation of HZV infection.

    Herpes Zoster: Coalesced vesicles resulting from reactivation of HZV infection.

  • Herpes Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

    Herpes Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

  • Herpes Zoster: Dermatomally distributed vesicles in patient with HZV infection.

    Herpes Zoster: Dermatomally distributed vesicles in patient with HZV infection.

  • Herpes Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

    Herpes Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

  • Shingles on waist

    Shingles on waist

  • Dermatomal involvement of rash

    Dermatomal involvement of rash

  • Dermatomal involvement of skin rash

    Dermatomal involvement of skin rash

  • Herpes zoster on the chest

    Herpes zoster on the chest

  • Varicella zoster

    Varicella zoster

  • Herpes Zoster. (Courtesy of Josh Fierer, M.D. and Charlie Goldberg, M.D.)

    Herpes Zoster.
    (Courtesy of Josh Fierer, M.D. and Charlie Goldberg, M.D.)

  • Herpes Zoster C3 Distribution: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

    Herpes Zoster C3 Distribution: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

  • Herpes Zoster C3 Distribution: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

    Herpes Zoster C3 Distribution: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

  • Shingles on face

    Shingles on face

  • Shingles on face

    Shingles on face

  • This 1968 image depicted a number of varicella, or chickenpox lesions on a patient’s back, which were displaying the characteristic “cropping” distribution, or manifesting themselves in clusters, each in a different developmental stage.

    This 1968 image depicted a number of varicella, or chickenpox lesions on a patient’s back, which were displaying the characteristic “cropping” distribution, or manifesting themselves in clusters, each in a different developmental stage.

  • This patient presented with what was differentially diagnosed as a herpes zoster outbreak in order to rule out syphilis.

    This patient presented with what was differentially diagnosed as a herpes zoster outbreak in order to rule out syphilis.

  • This skin disorder was found to be herpes zoster, not syphilitic in nature as was initially suspected.

    This skin disorder was found to be herpes zoster, not syphilitic in nature as was initially suspected.

  • These skin lesions on the forehead of an elderly woman are due to the herpes zoster virus on the 21st day of the illness.

    These skin lesions on the forehead of an elderly woman are due to the herpes zoster virus on the 21st day of the illness.

  • A case of shingles that demonstrates the typical dermatomal distribution, in this case C8/T1

    A case of shingles that demonstrates the typical dermatomal distribution, in this case C8/T1

Head
Trunk
Extremities
Neck
Genitourinary System
Skin

(Images shown below courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)

  • Herpes Zoster: Coalesced vesicles resulting from reactivation of HZV infection.

    Herpes Zoster: Coalesced vesicles resulting from reactivation of HZV infection.

  • Herpes Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

    Herpes Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

  • Herpes Zoster: Dermatomally distributed vesicles in patient with HZV infection.

    Herpes Zoster: Dermatomally distributed vesicles in patient with HZV infection.

  • Herpes Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

    Herpes Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

  • Shingles on waist

    Shingles on waist

  • Dermatomal involvement of rash

    Dermatomal involvement of rash

  • Dermatomal involvement of skin rash

    Dermatomal involvement of skin rash

  • Herpes zoster on the chest

    Herpes zoster on the chest

  • Varicella zoster

    Varicella zoster

  • Herpes Zoster. (Courtesy of Josh Fierer, M.D. and Charlie Goldberg, M.D.)

    Herpes Zoster.
    (Courtesy of Josh Fierer, M.D. and Charlie Goldberg, M.D.)

  • Herpes Zoster C3 Distribution: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

    Herpes Zoster C3 Distribution: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

  • Herpes Zoster C3 Distribution: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

    Herpes Zoster C3 Distribution: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection.

  • Shingles on face

    Shingles on face

  • Shingles on face

    Shingles on face

  • This 1968 image depicted a number of varicella, or chickenpox lesions on a patient’s back, which were displaying the characteristic “cropping” distribution, or manifesting themselves in clusters, each in a different developmental stage.

    This 1968 image depicted a number of varicella, or chickenpox lesions on a patient’s back, which were displaying the characteristic “cropping” distribution, or manifesting themselves in clusters, each in a different developmental stage.

  • This patient presented with what was differentially diagnosed as a herpes zoster outbreak in order to rule out syphilis.

    This patient presented with what was differentially diagnosed as a herpes zoster outbreak in order to rule out syphilis.

  • This skin disorder was found to be herpes zoster, not syphilitic in nature as was initially suspected.

    This skin disorder was found to be herpes zoster, not syphilitic in nature as was initially suspected.

  • These skin lesions on the forehead of an elderly woman are due to the herpes zoster virus on the 21st day of the illness.

    These skin lesions on the forehead of an elderly woman are due to the herpes zoster virus on the 21st day of the illness.

  • A case of shingles that demonstrates the typical dermatomal distribution, in this case C8/T1

    A case of shingles that demonstrates the typical dermatomal distribution, in this case C8/T1

References

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