Reactivation of varicella-zoster virus typically presents as which condition characterized by a unilateral, painful vesicular eruption?

• A. Shingles
• B. Varicella
• C. Measles
• D. Rubella

Answer: (A)

Reactivation of varicella-zoster virus produces herpes zoster, also known as shingles. After a person recovers from chickenpox, the virus can remain latent in sensory nerve ganglia (dorsal root or cranial nerve ganglia). When it reactivates, it travels along a sensory nerve to the skin, causing a painful, vesicular eruption that follows a single dermatomal distribution on one side of the body or face. The pain is often prominent and may precede the rash by hours to days, and the vesicles crust over in a few weeks. This unilateral, dermatomal, painful vesicular pattern is the hallmark of shingles.

In contrast, primary varicella (chickenpox) presents as a generalized, pruritic vesicular rash with fever and starts in multiple areas, not confined to a dermatomal distribution. Measles and rubella cause fever and maculopapular rashes with characteristic accompanying symptoms and signs, not vesicular lesions in a dermatomal pattern.