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Image Number 624 (Herpes Zoster)


Diagnosis: Herpes Zoster

Site: Chest

Sex: M

Age: 23

Type: Clinical

Description: Multiple non-painful groups of vesicles, on an erythematous base.

Submitted by: Mehravaran Mehrdad

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Differential Diagnosis

History: Shingles or herpes zoster is characterized by painful small grouped vesicles occuring on an inflamed base and and ususally localized to one or two dermatomes without crossing the midline. It is the result of a reactivation of latent varicella-zoster virus, the incidence increasing with advancing age. Although not as contagious as the primary infection (varicella), it can still cause varicella in those previously not infected. Pain is the most frequent problem with herpes zoster, its incidence, severity, and duration increasing with age. Postherpetic neuralgia, defined as a pain lasting longer than 1 month, is seen in 10-15% of patients. It resolves within 2 months in 50% of patients and within 1 year in 75%, but it may persist for many years in a small percentage. This case, a 23 year-old male without any complication (not even painful herpetic lesions) ,was treated with acyclovir 800mg, 5 times a day for 7 days. The patient recovered fully after 2 weeks and HIV screening test was negative.

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