Zoster sine herpete is an uncommon
manifestation of herpes zoster virus infection and
presents with pain in a dermatomal distribution
without the rash of cutaneous zoster.
Therefore, in the absence of a rash, clinicians should pursue a
diagnostic workup.
Positive immunoglobulins
A and M are serologic indicators to help diagnosis,
although there are challenges to interpreting the
results because they can be indications of primary
infection, reinfection, or reactivation.