Which statement about shingles is correct?

• A. It is caused by reactivation of varicella-zoster virus in a dermatomal distribution.
• B. It always affects both sides of the body.
• C. It commonly presents with a painful vesicular rash in a dermatomal distribution.
• D. It resolves without treatment.

Answer: (C)

Shingles happens when varicella-zoster virus remains latent in a sensory ganglion after a chickenpox infection and reactivates to travel along a sensory nerve to the skin. The hallmark is a unilateral, painful vesicular eruption that follows the course of a single dermatologist (dermatome). This combination—neural-type pain with grouped vesicles confined to one dermatome—captures the typical clinical picture, which is why describing it as a painful vesicular rash in a dermatomal distribution is the best statement. The underlying reactivation explains the dermatomal pattern, but what clinicians most readily recognize and diagnose is the painful, vesicular rash along one dermatome. It’s not usually bilateral, and many cases benefit from antiviral therapy to speed healing and reduce complications like postherpetic neuralgia, though some cases may resolve without treatment with supportive care. Additional context: the rash generally progresses from red patches to vesicles, and it tends not to cross the midline.