Concluded Case

Herpes Zoster

62 years old female with these sudden onset lesions on face below right eye with vague irritation right side , watery discharge from right eye . Is it Herpes Zoster ? As pain is distributed in the area of trigeminal nerve

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Concluded answer

Typical herpes zoster lesions are not seen. Sharply demarcated area of hyperaemia is seen. DD irritant CD? It is known that rarely a pt may have pain without skin lesions known as ZOSTER SINE HERPETE.

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Herpes Zoster Ophthalmicus (HZO), It is commonly known as shingles, is a viral disease characterized by a unilateral painful skin rash in one or more dermatome distributions of the fifth cranial nerve (trigeminal nerve), shared by the eye and ocular adnexa. Corticosteroid eye drops .

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? HERPES ZOSTER OPHTHALMIC.. NEED'S.. * ACYCLOVIR..ORALLY AS WELL.. EYE OINTMENT.. * GABAPENTIN WITH NEUROTROPHIC VITAMINS.. * SYMPTOMATIC T/T

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Yes herpes zoster 0phathalmicus. Neosporin eye ointment locally.Tab acyclovir 800mg 1tds.Cap pregabalin 75mg +methylcobalmin 1500mg 1od×7days.

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D.D : Toxic dermatitis following insect hit to affected skin . ..erysipelas like infection of lid skin. Rx : . . Oral ciprofloxacin . .oral dexamethasone. .oral paracetamol. . Topical antibiotics-steroid e/drops. . Chloramphenicol with polymyxin-b with dexamethasone e/ointment to be applied on affected skin 3 times in a day.

Apparently Herpes zoster Ophthalmicus Acyclovir Neurobion Analgesic

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Typical herpes zoster lesions are not seen. Sharply demarcated area of hyperaemia is seen. DD irritant CD? It is known that rarely a pt may have pain without skin lesions known as ZOSTER SINE HERPETE.

Since the features indicate early evidence of HZO and strictly on one side it is better to treat with proper dosage of acyclovir

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*Paederus dermatitis ** HZO Treatment as suggested above by colleagues.

Thanks Dr Sabita Naaz
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Two thing in mind 1. Paederus dermatitis 2. Herpes zoster infection Experts please opine

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Yes sir it is varicella zoster

Thanx dr Vipin Bihari Jain
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