Diagnosis of shingles
Both varicella and shingles are diagnosed by the clinical picture. The rash is very typical. A targeted search for the pathogen is only conducted in case of atypical courses, e.g., in very young patients or with unclear symptoms.
A physician should be consulted immediately at the first sign of shingles.
It is crucial to receive an immediate diagnosis to initiate early antiviral treatment against shingles.
Therapy is most effective if started within the first three days (72 hours) after the blisters have appeared.
Disease progression
Shingles is a very painful inflammation of the nerves, usually accompanied by a vesicular rash.
Shingles usually progresses in phases:
4 days to 2 weeks
1. Prodromal phase
lasts from 4 days to 2 weeks and may be characterised by headache, sensitivity to light, malaise, tenderness, pain or fever
2 to 4 weeks
2. Acute phase
lasts from 2 to 4 weeks and is usually associated with a one-sided, vesicular rash as well as acute pain.
Months or even years
3. Chronic phase
5-30 % of patients may develop postherpetic neuralgia, which is characterized by nerve pain that can last for months or even years.
Atypical courses of the disease
Atypical or generalised courses of the disease primarily occur in immunocompromised patients.
