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Herpes Zoster

Herpes Zoster is a topic covered in the 5-Minute Emergency Consult.

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  • Commonly known as shingles
  • Characterized by unilateral eruption of painful vesicles along a single dermatome
  • Disseminates rarely in normal hosts and frequently in immunocompromised hosts
  • Most common in patients with decreased cell-mediated immunity:
    • Older than 50 yr of age
    • Neoplastic diseases
    • Immunosuppressive drugs


  • Caused by varicella zoster virus (VZV), a DNA virus in the Herpesviridae family
  • Reactivation of dormant virus in dorsal root ganglia
  • Mostly in individuals who previously had chickenpox and very rarely in vaccinated individuals

Pregnancy Considerations
Zoster in pregnancy is not associated with increased risk of congenital varicella syndrome

Pediatric Considerations
May occur in childhood, most commonly when primary varicella occurred in utero or in the first 6 mo of life

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Rosen, Peter, et al., editors. "Herpes Zoster." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307580/all/Herpes_Zoster.
Herpes Zoster. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307580/all/Herpes_Zoster. Accessed April 25, 2019.
Herpes Zoster. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307580/all/Herpes_Zoster
Herpes Zoster [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307580/all/Herpes_Zoster.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Herpes Zoster ID - 307580 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307580/all/Herpes_Zoster PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -