On December 1st, a middle-aged man came to see me with rashes on the right side of his trunk, both front and back, presenting in a band-like fashion. Medically, this is referred to as "along the dermatome." Observing the lesions and the pattern of involvement, I immediately recognized the condition as shingles, also known as herpes zoster. This condition is caused by the same virus that leads to chickenpox—the varicella-zoster virus. After an individual has chickenpox, some of the virus can remain dormant in the spinal nerve roots. Later, when the virus reactivates, it produces localized skin lesions in the area supplied by the affected nerve, rather than the widespread lesions seen in chickenpox.
During the initial visit, I prescribed antiviral tablets, ointments, and additional medications to alleviate his symptoms.
Four days later, he returned to my office. Some of the blisters had enlarged, while others had burst and dried up. He was experiencing fever, body aches, and a headache. I adjusted his medication and provided further counseling.
He came back again after 12 days. The lesions had dried up, leaving some scars, but he was now experiencing a burning sensation and pain in the affected area. His symptoms suggested post-herpetic neuralgia, a painful condition that can persist for three months or longer. The burning pain is a result of nerve involvement. I prescribed additional medication to help improve his symptoms.
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