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[Herpes zoster: clinical manifestation, diagnosis and treatment]

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Herpes zoster (HZ) is a painful vesicular rash localized to one dermatome. Post-herpetic neuralgia (PHN) is persistent pain three months after the rash started. In recent years several Cochrane reviews and clinical studies on how to treat HZ and PHN have been published. These studies show that early recognition and treatment can reduce acute symptoms, that antiviral therapy and corticosteroids shorten the acute illness period, that opioids and anticonvulsants have effect on acute HZ pain and, finally, that tricyclic antidepressants, opioids and anticonvulsants all have proven efficiency in PHN therapy.

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Herpes zoster is a reactivated varicella-zoster virus infection and demonstrates typical dermatomal distribution. We herein describe a case of a 41-year-old woman with a history of ovarian cancer. Intense hot uptake in the left breast and enlarged ipsilateral axillary lymph nodes were noted on F-FDG PET/CT for adjuvant chemotherapy response evaluation. Blinded to the patient's clinical information, these lesions were interpreted as incidental breast cancer with axillary nodal metastasis. However, clinically she presented with vesicles along the T4 dermatome and palpable enlarged nodes in the left axilla. On 3-month follow-up PET/CT after antiviral treatment, these intense hot uptake areas were no longer visualized.
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