Diagnose based on clinical symptoms: prodromal phase with abnormal skin sensations and pain in the affected dermatome, ain can be described as burning, stabbing, or throbbing; can be intermittent or constant, and may be so severe it interferes with sleep and quality of life. Headache, photophobia, malaise, and fever (less common) may also occur as part of the prodromal phase. Within 2–3 days (more rarely up to 7 days), a rash typically appears in a dermatomal distribution. It starts as maculopapular lesions then develops into clusters of vesicles, with new vesicles continuing to form over 3–5 days. The rash is usually painful, itchy, and/or tingly, and, unlike other rashes, does not cross the midline of the body. The vesicles then burst, releasing varicella-zoster virus, and crust over within 7–10 days. Healing occurs over 2–4 weeks, and often results in scarring and permanent pigmentation in the affected area.