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Review
. 2023 Aug;12(4):893-901.
doi: 10.1007/s40122-023-00510-4. Epub 2023 May 2.

Early Diagnosis of Herpes Zoster Neuralgia: A Narrative Review

Han-Rui Fan #  1 , En-Ming Zhang #  1 , Yong Fei  2 , Bing Huang  3 , Ming Yao  3
Affiliations
Review

Early Diagnosis of Herpes Zoster Neuralgia: A Narrative Review

Han-Rui Fan et al. Pain Ther. 2023 Aug.

Erratum in

Abstract

Background: Early intervention reduces the incidence of postherpetic neuralgia (PHN). Typical shingles are easy to diagnose; however, there is no clear diagnostic method for neuralgia symptoms manifested before the onset of the rash, which can easily cause misdiagnosis. This not only increases the patient's pain, medical expenses, and mental burden, but more importantly, delays the valuable time for early treatment of shingles, and increases the probability of complications and PHN.

Objective: In this paper, the diagnostic methods of preherpetic neuralgia were summarized and analyzed, and the current challenges were put forward to provide directions for the early diagnosis of herpes zoster (HZ) in the future.

Methods: PubMed, and China National Knowledge Infrastructure (CNKI) libraries were searched using the terms "herpes zoster," "before the blistering," "diagnosis," and "neuralgia." Clinical trials, reviews, and case reports were collected and reviewed. The period of literature search is from 1 January 1980 to 1 October 2022.

Results: The early diagnosis of herpes zoster neuralgia can reduce misdiagnosis and mistreatment, and timely and effective intervention can significantly reduce the incidence of PHN. The body may possess a mechanism that limits the local breakthrough of the virus in the skin, causing blistering later than the onset of pain. Changes in the plasma proteins of patients with varicella-zoster virus shingles neuralgia may be used as an early diagnostic indicator in patients with HZ neuralgia before eruption.

Conclusion: Early diagnosis of HZ neuralgia before eruption can facilitate timely targeted treatment, thereby reducing the incidence of PHN. Proteomic quantitative analysis and validation results can serve as a simple, micro, rapid, and accurate diagnostic method.

Keywords: Antibody titer; Biomarker; Early diagnosis; Herpes zoster; High-frequency ultrasonography; Polymerase chain reaction; Thermography; Varicella‐zoster virus.

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Conflict of interest statement

The authors have no relevant disclosures. Han-Rui Fan has nothing to disclose. En-Ming Zhang has nothing to disclose. Yong Fei has nothing to disclose. Bing Huang has nothing to disclose. Ming Yao has nothing to disclose.

Comment in

References

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