RT Book, Section A1 Hardin, J. Matthew A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181043884 T1 Herpes Zoster T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181043884 RD 2024/03/28 AB Herpes zoster is a dermatomal, unilateral reactivation of the varicella zoster virus. All ages, including infants, can be affected. The eruption may occur anywhere but most commonly occurs on the face and trunk. Pruritus, pain, tenderness, and dysesthesias may present 4 to 5 days prior to an eruption composed of umbilicated, grouped vesicles on an erythematous, edematous base. The vesicles may become purulent or hemorrhagic. Occasionally, nerve involvement may occur without cutaneous involvement. Rare presentations involve multiple dermatomes or cross midline. Ophthalmic zoster (see related item) involves the nasociliary branch of the 5th cranial nerve and presents with vesicles on the nose and cornea (Hutchinson sign). Ramsay Hunt syndrome (see related item) is a herpes zoster infection of the geniculate ganglion with tinnitus, decreased hearing, facial palsy, and vesicles on the tympanic membrane, pinna, and ear canal.