Question

27 year-old woman with AIDS presents complaining of a painful, puritic, and papular rash. What's the diagnosis?

Answer

Answer: Herpes zoster ophthalmicus

Herpes Zoster Ophthalmicus

• Zoster involving the ophthalmic branch (V1) of the trigeminal nerve
• Concomitant nasal rash is called Hutchinson's sign and heralds involvement of the eye (specifically the cornea); the nasociliary nerve innervates both the nose and eye
• Must perform a thorough evaluation of the eye including slit lamp and fluorescein
• Consider admission if:
  • symptoms are severe 
  • 2 or more dermatomes are involved
  • patients are immunocomprosmised
• ​Treatment is with ​acyclovir, valacyclovir, or famciclovir

References

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