The invisible pain

Herpes zoster is a very easy diagnosis when you see it with the typical vesicles and erythema, but can be also a disturbing experience for a clinician

Before the skin changes there is a prodromal phase where the patient can feel a strong pain, usually following a metameric distribution, but the clinician can only suspect the diagnosis. It is not uncommon to read ” nephritic colic” or urinary infection or pyelonephritis in the medical records.

After the skin changes dissapears the pain can persist for months or years and can be a distractor for a proper diagnosis of another clinical situation