National Board of Chiropractic Examiners (NBCE) Practice Test

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Unilateral thoracic pain followed by the formation of vesicles in the same region is most characteristic of which condition?

Herpes simplex
Herpes zoster
Shingles
Chickenpox

The correct answer is: Herpes zoster

The formation of vesicles and unilateral thoracic pain is indicative of a specific viral infection, commonly associated with the reactivation of the varicella-zoster virus, which causes both chickenpox and shingles. When the virus reactivates later in life, it leads to shingles, also known clinically as herpes zoster. In cases of shingles, patients typically experience a sharp, burning pain localized to one side of the body, often following a dermatomal distribution. This is often seen in the thoracic area. Shortly after the onset of pain, vesicular lesions appear in the same region, which are clustered and filled with fluid. While herpes simplex could cause vesicles, it typically affects areas like the lips or genitals and doesn't follow the dermatomal distribution or unilateral presentation as seen in shingles. Chickenpox refers to the primary infection caused by the varicella-zoster virus during childhood and presents with a generalized rash rather than localized vesicles. The choice of shingles effectively captures the association between the unilateral pain and the subsequent appearance of vesicles in the same dermatome.