36 years female Multiple grouped vesicles on right palm Right arm..painful and burning sensation....HERPES ZOSTER. What are the dermatomes involved here? What are the specific tests for HZ. Any available vaccine and dosage, what precautions to take during vaccination?who is not fit for vaccine?


1)C5 dermatome 2) Tzanck smear (acantholytic cells plus giant cell) 3)zoster vaccine (zostavax) : live vaccine 4)contraindications : immunocompromised patients, patients on immunosuppressive drugs,
Vaccine can not prevent post medal.encelopathy

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Shingles Scraping of cell from base of lesion for direct fluoresent antibody test PCR Zoster vaccine is available and is recommended above 50yrs of age. Dosage. 0.65ml (entire vial) sc upper arm To be used within 30 mins of reconstruction Contraindications: Pregnancy Immunocompromised status Leukemia Lymphoma HIV positive persons Persons on immunosuppressants Below age of 50 yrs. Acute illness Active untreated TB. Do not use with 23 valent pneumococcal vaccine as it decreases efficacy Adrenaline must be available
Thank you Dr.Aniruddha for your Good and useful answer.

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Sir, Dermatome involved is C6. Tests for HZ include Tzanck smear, Direct flouroscent antibody test, PCR, ELISA. Zostavax is the available vaccine for HZ, it should be given Subcutaneously at a dose of 0.65 ml in deltoid. Care should be taken while giving the vaccine in breastfeeding women and in pregnant women. Not to be given in people with weak immune system, including Tuberculosis.
Thank you responding Doctors. 1) C 5 dermatome is involved. 2) Specific tests are DFA...Direct Fluorescent Antibody test. PCR...Polymerase Chaon Reaction assay. Both are specific and sensitive tests compare to TZANCK smear examination. But TZANCK is cheap and best . It can identify the HZ, but can't differentiate the HZ and other herpes viruses. 3) Regarding VACCINE: ZOSTER vaccine available as ZOSTAVAX from Merck & Co reduce the incidence of HZ. It is advisable after 60 years of age. Because risk between 50 and 59 is less intensity. Contraindications: a) weakened immune system like HIV/AIDS, debilitated conditions. b) on cancer treatment patients. c) on use of steroids d) pregnancy
Sir it is C6 dermatome Zostavax vaccine to be given in deltoid region s/c Not to be given in immunocompromised patients, pregnant women
Agree to dr Aniruddha First think HIV For burning...apply desi cow ghee...rest alll
Herpes Zoster Acyclovir 800mg 5 times for 7 days Dolokind plus SOS (as per requirement) Levocetirizine 5mg bid for 10 days Acyclovir ointment twice daily
Thanks Dr Kishore for posting a case of immense importance for Drs from all specialities. Thanks all curofian for nice comments.
Herpes zoster...c5 dermatome involved....zostavax vaccine...contraindicated in immunocompromised patients
Herpes zooster acryovir and mometasone cream ,methyl cobalmine tab
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