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학습 자료 둘러보기 →The hallmark of herpes zoster is a unilateral vesicular rash that strictly follows a dermatome and does not cross the midline. This occurs because the latent varicella-zoster virus reactivates in a single dorsal root ganglion and travels down the sensory nerve to the skin.
Patients often report prodromal pain—described as burning, tingling, or stabbing—in the affected dermatome 1 to 5 days before the rash appears. The pain can be severe and may be mistaken for other conditions like myocardial infarction or cholecystitis depending on the location.
If a patient with a dermatomal rash develops widespread, scattered vesicles, consider disseminated zoster, which requires urgent evaluation and systemic antiviral therapy. Always use standard and airborne precautions for localized zoster if the patient is immunocompromised or the rash is disseminated.
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