Herpes zoster is a skin lesion characterized by vesicles and bullae following multiple contiguous dermatomes, usually in a unilateral distribution and associated with severe pain. It is more commonly seen among HIV infected patients.

Diagnosis is based on the following symptoms:

• The presence of grouped vesicles and bullae on the background of oedematous and erythematous skin,

• Appearance of vesicles and bullae on one side of the vertebrae, but involving multiple dermatomes in a ribbon fashion and

• Association with severe pain.

Treatment

Acyclovir, 200mg, p.o. 5 times daily for 7 days, or 5 mg/kg body weight i.v. every 8 hours for 7 days.

Topical acyclovir may also be applied 5 times daily in mild cases or in addition to systemic therapy in severe forms. (For S/E, C/I and dosage forms, see page 94)

Note:

Broad spectrum antibiotics (tetracycline, amoxicillin, etc.) might be needed to avoid secondary infection (see pyoderma). After the vesicles have resolved, if the patient complains of neuralgia low dose systemic steroid, e.g. l5-30mg of daily prednisone or its equivalent, may be used. Topical therapy in the acute state includes disinfectant solution or antibiotics.