el Hayderi et al described the clinical and laboratory findings for patients with Herpes zoster (HZ). These can help to identify a patient with severe disease. The authors are from the University of Liege in Belgium.
Patient selection: adult with Herpes zoster
Examination:
(1) dermatome(s) affected, may be single or multiple: cephalic, cervical, thoracic, lumbar and/or sacral
(2) grade of surface area involvement (affected area, see table below)
(3) satellite lesions: skin lesion >= 5 cm away from primary dermatome
(4) stage of lesions (see below)
(5) systemic signs: fever, lymphadenopathy, malaise and/or headache
(6) viral load in blood in copies per mL
|
Affected Area
|
Grade
|
|
< 10 square cm
|
1
|
|
10 to 50 square cm
|
2
|
|
> 50 square cm
|
3
|
The stages of HZ lesions may be papular, vesicular, pustular or crusted. If all lesions are of the same stage then termed single stage. If lesions are of different stages then termed multistage.
Patients with severe HZ (associated with disseminated disease) tended to have:
(1) high viral load in blood
(2) satellite lesions and multiple dermatomes
(3) immunocompromised status
(4) need for hospitalization
(5) visceral involvement
