National Physical Therapy Examination (NPTE) Practice Exam

Which symptoms are MOST characteristic of herpes zoster?

1. Unilateral scales along the affected dermatome followed by numbness and burning

2. Bilateral scales along the affected dermatomes followed by numbness and burning

3. Pain and paresthesia followed by a unilateral rash along the affected dermatome

4. Pain and paresthesia followed by a bilateral rash along the affected dermatomes

The correct answer is: Pain and paresthesia followed by a unilateral rash along the affected dermatome

The symptoms characteristic of herpes zoster, also known as shingles, typically include pain and paresthesia that precede the appearance of a rash. This rash is usually unilateral, meaning it affects only one side of the body, and corresponds to a specific dermatome where the virus reactivates after being dormant in the sensory ganglia. The initial phase often presents with pain, burning sensations, or tingling in the affected area, which can be quite intense. This is frequently followed a few days later by the eruption of a vesicular rash that follows the distribution of the affected sensory nerve, distinctly outlining a dermatome. The unilateral nature of the rash is key, as herpes zoster does not usually present bilaterally. Understanding the characteristic presentation helps differentiate herpes zoster from other conditions, such as varicella zoster (chickenpox), which produces a more generalized rash and systemic symptoms, or other dermatoses which may not follow a strict dermatome. Thus, the presence of pain and paresthesia, followed by a rash that is unilateral and localized to a specific dermatome, effectively encapsulates the typical clinical presentation of herpes zoster.