In clinical practice, a patient with herpes zoster has only neuropathic pain without skin lesions. We refer to this type of herpes zoster as a constricted herpes zoster.
This type of herpes zoster often occurs in patients with relatively strong immune function, and some patients with recurrent herpes zoster can also behave this type.
What are the countermeasures for this type of herpes zoster?
First, although this type of herpes zoster does not present skin lesions, it still has the typical characteristics of herpes zoster neuralgia, namely unilateral, paroxysmal, and acupuncture-like severe pain.
Second, we must distinguish between the following types of diseases:
(1) When it occurs in the chest and back, it needs to be differentiated from angina pectoris, intercostal neuritis, and pleurisy.
(2) In the abdomen, it should be differentiated from pancreatitis, appendicitis and acute abdomen.
(3) occurs in the lower limbs and should be differentiated from sciatica. Third, in general, the diagnosis of frustrated herpes zoster is an exclusive diagnosis. In addition to analyzing the characteristics of neuropathic pain, it is necessary to perform necessary examinations such as chest X-ray, CT, blood routine, and pancreatic amylase to exclude other illnesses.
When herpes zoster patients only show erythema and papules without blisters, we call this herpes zoster a herpes zoster.
Note that it is different from the above-mentioned constricted herpes zoster: the constricted herpes zoster only shows neuralgia without skin lesions.
Incomplete herpes zoster is also common in some patients with relatively strong immunity, and in the first few days of herpes zoster, patients can also present with herpes zoster. Incomplete herpes zoster is better diagnosed than frustrated herpes zoster, but if not noticed, it may also cause misdiagnosis.
In general, there are several reasons:
First, there is a lack of awareness and vigilance against incomplete herpes zoster. Herpes zoster is more common with clustered blisters. Only pa