1. Typical manifestations Before the onset of the rash, there may be mild malaise, low-grade fever, poor circulation and other systemic symptoms, and the affected skin may feel burning sensation or neuralgia, and there is obvious pain sensitivity to touch, lasting 1 to 3 days. The most common sites are the intercostal nerve, cervical nerve, trigeminal nerve and lumbosacral nerve innervation areas. The affected area often first appears as a flushed spot, followed by corn- to soybean-sized papules, which are distributed in clusters and do not fuse, and then rapidly turn into blisters with tense, shiny walls and clarified fluid, surrounded by a red halo, with normal skin between clusters of blisters; the lesions are arranged in a band along a peripheral nerve, mostly on one side of the body, and generally do not exceed the midline. Neuralgia is one of the characteristics of the disease and can occur before the onset of the disease or with the lesions, and is often more intense in older patients. The course of the disease is usually 2 to 3 weeks, after the blisters dry up and the crusts fall off, there are temporary light red spots or pigmentation. 2, special manifestations (1) ocular herpes zoster. It is a viral invasion of the ophthalmic branch of the trigeminal nerve, mostly in the elderly, with severe pain, and can involve the cornea to form ulcerative keratitis. (2) Ear herpes zoster. It is caused by viral invasion of the facial and auditory nerves and manifests as herpes of the external auditory canal or tympanic membrane. When the geniculate ganglion is involved and the motor and sensory nerve fibers of the facial nerve are also invaded, a triad of facial palsy, otalgia, and herpes in the external ear canal can occur, called Ramsay-Hunt syndrome. (3) Postherpetic neuralgia. Herpes zoster is often associated with neuralgia, which can occur before the onset of the rash, during the onset of the rash, and after the lesions have healed, but mostly disappears after the lesions have completely resolved or within 1 month. (4) Other atypical herpes zoster. It is related to the difference in the resistance of the patient’s organism and can manifest as strophic (no lesions but neuralgia), incomplete (only erythema and papules appear without blistering and regress), maculopapular, hemorrhagic, gangrenous, and generalized (involving more than 2 ganglia at the same time and producing lesions in multiple areas contralateral or ipsilateral). Herpes zoster.