?Herpes(Shingles)

52 year old male farmer by occupation Chief Complaints Complaints of onset of lesions over right side forehead 4 days back which are typically described by him as Herpes like, which progressed to such state as shown after application of local agents, he adds that the left eye is swollen too over the night now Diagnosis Herpes (Shingles) Management Can we add steroids to his treatment to tackle swelling?

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Ophthalmic zoster.. Shingles involving the eye. Symptoms generally include a rash of the forehead with swelling of the eyelid. There may also be eye pain, eye redness, and light sensitivity. Herpes zoster ophthalmicus occurs when reactivation of the latent virus in the trigeminal ganglia involves the ophthalmic division of the nerve. The virus damages the eye and surrounding structures by secondary perineural and intraneural inflammation of sensory nerves. Oral acyclovir 800 mg PO five times daily for 7 to 10 days is the standard treatment.

Famcyclovir? Can be used?
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Yes herpes zoster with opthalmicus Lesions are spread all over forehead rt side and in periorbital area Rx tab azithromycin 500mg 1od for 5days Tab acyclovir 800mg 5times a day for 7days Locally acyclovir oint frequently Acyclovir opthalmic oint to be instilled in eye Tab Levocetrizine5mg 1bd Tab gabapentin 300mg+nortryptiline 10mg 1od at bedtime NSAIDs Tab neurobion forte 1od Sos xylocaine gelly for instant relief

Thanx dr Kute Ankush
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? HZO.. NEED'S.. ACYCLOVIR ORALLY AS WELL TOPICALLY.. GABAPENTIN WITH NT .. NEUROTROPHIC VITAMINS.. ANALGESICS ANTIINFLAMMATORY.. AZITHROMYCIN.. BILASTINE..

Tnx Dr Vipin Bihari Jain sir
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Herpes Zoster with opthalmus Tab Herpex 800 mg 5 times daily Acyclovir oint locally Tab Ceftum 1000 mg bd Tab Serra 2 bd Anti inflammatory Tab Gabapentine 300 mg bd

Obviously Herpes zoster Acyclovir ointment locally Acyclovir 800 5 times daily for 10 days Dolonex DT 1bd Neurobion 1bd

Thanks Dr. Dinesh Gupta, Dr. Kute Ankush, Dr. Pushker Bhomia, Dr. Ajeet Pal Singh
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Main stream of treatment of Herpes Zoster is anti viral drugs for 7-10 days. Use of Oral Steroid is controversial. Immunosuppression by corticosteroids may affect the therapeutic effect and safety of patients with herpes zoster. Reference to ophthalmologist must be done as early as possible to prevent ophthalmic complications. Oral steroid may not prevent Post Heretic Neuralgia.

Steroids preferably to be avoided as it may decrease immunity and cause increased severity of disease Adv Acyclovir 800 mg five times a day for 10 days

No steriod Hz Opinion of opthalmologist Acylovir 800 5 times a day 5 to7 days

SUGGESTIVE. OF HERPES ZOSTER OPHTHALMICUS SHINGLES NEEDS PARENTERAL. MANAGEMENT

Herpes zoster

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