Symptoms of shingles
Herpes zoster (shingles) occurs preferentially in the elderly or with immune deficiencies (e.g. AIDS, leukemia). In most cases, the infection is limited to one or more dermatomes (area of spread of a nerve). In contrast to chickenpox, which affects the entire body, shingles occurs locally.
The affected skin segments are characterized by very painful and grouped standing blisters on reddened ground. The blisters contain liquid containing the virus. After a few days of the painful phase, several inflammatory foci with clear blisters form.
2-7 days later the blisters are cloudy and yellowish, the redness subsides and the skin becomes pustular and bleeding. Dehydration now begins. After 2-3 weeks the blisters have healed and left light scars.
In addition to very severe pain in the case of shingles, fever can also occur. A characteristic feature of a herpes zoster infection or shingles is the occurrence of specific pain in a certain body/skin area that is supplied by a nerve of the affected ganglion (= accumulation of nerve cell corpuscles). The pain often begins several days before the onset of the actual, classic shingles rash and is accompanied by itching in this area.
In the initial acute phase, a dull-burning pain predominantly occurs, which can often be intensified by movement. It is triggered by the fact that infection with the herpes zoster virus leads to the release of chemical substances that irritate the pain receptors (nociceptors) in the affected area. In medical terminology, this is therefore also referred to as nociceptive pain.
In the further course of the disease a neuropathic pain occurs, which is a pain of the nerves themselves. Its origin is due to the viruses that attack the nerves and spread through their pathways. During the entire phase of the disease, this sharp pain can often be triggered by light touch. Sometimes the pain is accompanied by a tingling sensation or in exceptional cases by paralysis. In some patients the neuropathic pain persists beyond the actual course of the disease, in this case it is called post-zoster neuralgia.
