A. Zoster is usually heralded by dermatomal pain, sometimes accompanied by fever. Within a few days, the skin overlying the dermatome reddens and blisters. A few vesicles are usually grouped on one erythematous base, in contrasttothe scattered, single vesicles of chickenpox. Several days later the vesicles become pustular and develop crusts, followed by scabs.
B. Zoster may occur in any dermatome, but the thoracic dermatomes are most often affected. In 90% of patients, pain eventually disappears completely.
C. The frequency of zoster increases markedly after age 55, but people of any age can be affected. Less than 5% of immunocompetent patients who have one episode of herpes zoster will have another, and the episodes are usually separated by years. HIV-infected patients are more likely to have recurrent herpes zoster infections.
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