Shingles also commonly known as herpes zoster is a viral disease caused by varicella zoster virus. It is the same virus that causes chickenpox. The disease chickenpox gets cured within few days but the virus is not killed. It stays latent in the nerve roots of the spinal cord. It gets reactivated under favorable circumstances later in life to cause shingles.
Most people are aware of shingles due to severe pain and blisters or skin rash on the body. However, in rare cases shingles may appear with pronounced pain but without any rash or blisters.Since the typical one sided linear rash and blister is missing, the condition is often difficult for a medical practitioner to diagnose. Treatment of shingles without rash is similar to shingles present with blisters and rashes.
Symptoms Of Shingles Without Rash
As mentioned above, the most characteristic feature of shingles is appearance of blisters and pain. They are fluid filled blisters that develop in the area of skin innervated by the affected nerve. The rash in a typical case of shingles is almost always unilateral. It can occur on any side of the body, left or right.The usual place of occurrence of blisters and rash is on chest, neck, face, back, and arm. However, the disease can affect on any area of skin surface.
Before the appearance of tiny blisters, patient often complains of severe pain on the skin surface. After one or two days cluster of blister erupts on the affected nerve root in a linear manner. These symptoms are classical symptoms of shingles.
In rare cases shingles develop without appearance of blisters. Without classical rash it is difficult to diagnose shingles. The condition is often misdiagnosed, thus knowing the symptoms of herpes without rash will help to know the condition in a better way.
- Burning and shooting pain along the innervations of the nerve on the skin. Pain is also experienced in muscles. Since the typical rash is absent, the clinical diagnosis is often misinterpreted as some other ailment. For example if it occurs on chest, especially on left side physician may suspect it to be pain originating from heart or lung.
- Often fever is present with pain.
- Patient may also complain of body ache, headache, malaise etc.
- If shingles is present on arm or leg, patient may complain of weakness of the affected limb.
Complications Of Shingles Without Rash
Complications of shingles are severe if the condition remains untreated. One of the most common complications of shingles is post herpetic neuralgia. The affected nerve fibers after interacting with the virus may send exaggerated pain signals to the brain even after the infection has healed. Pain may be severe and striking. It may take few minutes to hours and days before it subsides only to return back after few days or hours.
Patient may develop neurological problems after the particular nerve is damaged. If shingles without rash has developed on face, there is risk of facial paralysis in some patients. It may also affect hearing and balance. Shingles can also affect the eyes. It can cause vision problems or permanent loss of eyesight.
Diagnosis And Treatment For Shingles Without Rash
Shingles is difficult to diagnose primarily due to absence of rash although there is pain. This is because many other ailments have pain as a symptom. In such cases often blood test for detecting varicella zoster virus is helpful. An immunoglobulin test such as IgM antibodies for varicella zoster virus is also beneficial for diagnosing the condition. There are many other tests such as polymerase chain reaction test to detect the virus.
Treatment of shingles without rash is similar to that of typical shingles that develop with rash. The first line of treatment is oral antiviral drugs. It is aimed to reduce the severity of pain, prevent complications and shorten the course of illness.
Besides anti viral medicines, homeopathic drugs are also beneficial for shortening and alleviating the disease. Homeopathic drugs such as Ars alb, Apis, Kali Mur etc are effective in dealing with shingles with or without rash.