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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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