Course of shingles
The course of shingles is generally divided into two phases. The first symptoms of shingles are initially very unspecific and consist of Only after the beginning of the acute phase do the disease-specific symptoms develop, which can now only be treated symptomatically. These symptoms include the formation of blisters, redness and severe pain in the affected skin area.
The affected skin area is usually described as belt-shaped, since only the skin area that is sensitively supplied by the affected nerve shows symptoms. In the course of the disease, there are often reports of sensations or numbness in the skin area. After about 4-5 days, the blisters filled with clear fluid burst and the formation of a wound crust begins.
14 days after the first symptoms appear, shingles has healed in most patients. This healing process can be accelerated by appropriate therapy with skin ointments.
- General lassitude,
- Tiredness,
- Limb Pain
- And fever.
- The prodromal phase (German: Vorläuferphase)
- And the acute phase.
Diagnosis
Important for the diagnosis of shingles are the symptoms and manifestations that are quite typical and directly obvious. Strongest pain drives the patients to the doctor and the typical distribution of blisters and redness is obvious. The pathogen can also be detected.
Here, both antigen (i.e. the virus (Herpres zoster) itself) and antibodies (against the body through the body’s immune reaction against the virus) can be detected. However, antibodies are already formed during the initial infection, i.e. chickenpox, and are therefore not well suited for the diagnosis of zoster shingles. In rare cases, shingles can occur without the formation of blisters or redness.
This phenomenon is known as ‘zoster sine herpete’. Such a manifestation makes the diagnosis more difficult, as the other symptoms, such as nerve pain, are not very specific for shingles. However, the basic course of shingles without rash or vesicles is similar to the normal course.
Initially, patients often report fatigue and exhaustion associated with fever. In addition, there is sensation of discomfort in the skin area, which is sensitively supplied by the affected nerve. After one or two days, the sensation changes to nerve pain, a so-called neuralgia, which is usually accompanied by severe itching.
To confirm the diagnosis of shingles, an antigen detection or virus culture is required in this case, as the specific symptoms of shingles are not present. The therapy for this type of shingles consists only of relieving the nerve pain until the shingles subsides. When zoster shingles begins, the following other diseases must be considered for differentiation:
- Pleurisy (= pleuritis)
- Pinched nerve
- Muscle inflammation
- Herpes simplex infection of the skin
