Key Points
  • Herpes zoster is caused by reactivation of the varicella-zoster virus (the cause of chickenpox) from its latent phase.

  • A painful rash, usually crops of vesicles on an erythematous base, develops on one or more adjacent dermatomes.

  • Fewer than 4% of patients have another outbreak of zoster, but many, particularly the elderly, have persistent or recurrent pain for months or years (postherpetic neuralgia).

  • Antivirals (acyclovir, famciclovir, valacyclovir) are beneficial, especially for immunocompromised patients.

  • Analgesics are often necessary.

  • Give adults  60 yr a single dose of zoster vaccine whether they have had herpes zoster or not.