Zoster

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍painful skin rash

Location is on ‍rightleft ‍faceneckarmhandlegfootthoraxabdomenflankback

Rated at ‍012345678910 / 10 ‍

Described as ‍dullaching

Symptoms include:

‍burning sensation

‍tingling

‍itching

‍blisters

‍crusting

‍fever, up to ‍°, over ‍ ‍hoursdays

‍headache, ‍diffuse, ‍persistentintermittent, ‍pressurethrobbing, ‍mild

‍fatigue

‍chills

‍nausea



Alleviating factors: ‍none, ‍effectiveineffective



Contributing factors:

‍unvaccinated

‍physical or emotional stress

no history of: ‍shingles, ‍chickenpox, ‍HIV, ‍cancer, ‍immunodeficiency

no use of: ‍corticosteroids





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Skin: ‍rashlesions on ‍





ASSESSMENT:

‍Herpes zoster ‍likelysuspectedpossible

DDx: herpes zoster, contact dermatitis, herpes simplex, impetigo, cellulitis, insect bites, drug eruption, photodermatitis, cutaneous lymphoma, sarcoidosis, psoriasis, lichen planus, fungal infection





PLAN:

Investigations:

- Varicella zoster virus PCR

Treatments:

- ‍Antivirals

- ‍Acetaminophen

- ‍NSAIDs

- ‍Topical treatments

- ‍Other pain medications

- Avoid contact with non-immune individuals (like infants)

Further care:

- Referral to dermatologist

- Referral to pain management specialist

- Consider Shinrix vaccine in 6-12 months

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop