How does an acute herpes zoster infection manifest itself?
The typical acute herpes zoster infection starts with pain in the affected area, which is usually described as burning or stabbing. During this time, the patient may have ’flu-like symptoms, such as fever or malaise. A few days later, lesions erupt. The lesions most commonly develop along one or more thoracic dermatomes, always unilateral and never crossing over the midline. Lesions may appear in the oph-thalmic division of the trigeminal nerve, the cervical der-matomes, or rarely the lumbar or sacral dermatomes. These lesions are described as erythematous vesicles and pustules. Over the course of about 4 weeks, the lesions crust over and heal, sometimes causing scarring in the area. The lesions are accompanied by severe pain, usually of a burning nature, although some patients also complain of achy, itchy pain. The pain is worse when the area is touched.