Herpes zoster is a clinical manifestation of reactivation of latent varicella-zoster virus (VZV) infection, which persists in sensory ganglia after primary varicella. The disease presents with a painful, unilateral vesicular rash following a dermatomal distribution, primarily affecting older adults and patients with impaired cell-mediated immunity. With advancing age, the incidence of herpes zoster and its complications, particularly postherpetic neuralgia, increases. Clinical progression includes prodromal, acute, and chronic stages, with possible neurological, ocular, or visceral complications. Diagnosis is primarily clinical, supported by laboratory methods such as PCR and serology. Early antiviral therapy, symptomatic care, and pain management are essential. Vaccination is an effective preventive measure, reducing both the risk and severity of the disease. Herpes zoster remains a clinically and socially significant condition, highlighting the importance of timely diagnosis, treatment, and prevention.
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