Shingles

Data gathering

  • Red flags
  • Others – initially numbness/pain/burning then rash (macules then vesicles)
  • Examine

 

Clinical management

  • Investigations
  • Explanation
    • infection of a nerve that supplies an area of skin
    • same virus as chickenpox
  • Treatment
    • contagious – until all blisters have scabbed over
    • avoid immunocompromised, pregnant women and babies
    • Aciclovir – within 72 hours (or 1 week if  >50 years old, immunocompromised, moderate pain)
  • Followup / Safety-net
    • Post herpetic neuralgia – residual pain/altered sensation – neuropathic analgesia