A shingles rash or shingles symptoms depends on the age and health of the patient, as well as the area or dermatome that's affected. Initially the first sign is usually pain, which may be mild or severe, and may be related to the sensory nerves that are involved. The pain may concentrate in one area or may be more widespread. The patient may have systemic or constitutional symptoms such as fevers and headaches. Lymph nodes that drain the affected areas may be enlarged or tender. Within one to three days of the onset of pain, a rash accompanied by blisters occurs in the area of pain of the skin. It begins as a group of reddish papules. New lesions will form for several days within the distribution of the affected areas. Each with blisters, pustules, or overlying crust. The areas that are most commonly affected in all age groups include the neck, cervical, chest, thoracic, forehead, ophthalmic and lumbar or saqual sensory regions. The frequency of ophthalmic herpes zoster also increases with age. Herpes zoster occasionally may cause blisters inside of the mouth or ears and can also affect the genital area. Sometimes there is pain without an accompanying rash or a rash without any pain, which can be seen in children. As the rash disappears, pain and its accompanied general symptoms also tends to decrease. In uncomplicated cases, most patients recover within two to three weeks in children and young adults, and within three to four weeks in older adult patients.
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