Diagnosis

diagnosis

Diagnosis of HZ is usually clinical.

If there is a diagnostic uncertainty, laboratory confirmation is required e.g. -:

• herpes zoster without a rash (zoster sine herpete)
• HZ of the face and genital areas, as these areas are the natural sites for recurrent labial and genital herpes respectively
• atypical mucocutaneous forms (1,2)

Fluid from vesicles may be used for polymerase chain reaction testing, viral culture, or direct immunofluorescent antigen staining (1).

Reference:

• (1) Fashner J, Bell AL. Herpes zoster and postherpetic neuralgia: prevention and management. Am Fam Physician. 2011;83(12):1432-7.
• (2) Werner RN et al. European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 1: Diagnosis. J Eur Acad Dermatol Venereol. 2017;31(1):9-19.