hey everybody welcome to this interesting case this is richard you may remember him from to be free some lesions on your skin yeah but they filled up and now you have something new is you can see it you can kind of see it on the on the other side of the space there on the his right side of his face has these
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lesions that showed up the Monday ringing woke up Monday which is going and what’s it feel like it’s a bitchy sense of a little bit of burning and even just like a breeze or when touching it is sensitive i don’t recall that part in the little sore even to something just touching it yeah fine bitches just like touch feels like a ping just a slight and it is especially on top of it here and it’s just on the right side it’s all on the right side like a lying down the middle so we’re all is quite suspicious for this being shingles because of its one-sidedness and the description of the sensation this very very sensitive to touch you say little Bernie maybe slightly itchy itchy is the morning but it doesn’t have the classic blisters or vesicles filled lesions structures that we see with the classic shingles
it also does not stick to one dermatome usually you’ll have it either above or below the eye not both above and below so we have some reasons to think it could be something else but there’s enough that suggests shingles that we need to treat as if it is and whenever we have shingles in the dermatome includes the I we need to refer to an eye specialist to do a special exam to make sure there’s no lesions on the eye and we already looked in the ear and saw there was nothing inside the earth normal and with close-up on these it looks like your pores have little scamp’s over them and they’re they’re swollen but it doesn’t look like true vesicles so this may not be shingles but we’re going to treat as if it is and if we’re able to have an update will certainly either put this caption or put it on the blog our medical group com where we put an entry for this but we’re going to treat with medicine called valacyclovir an antiviral medicine for the virus that causes shingles it treats viruses in the herpes family and we are also going to have available for you a medicine called neurontin or gabapentin case of hurts and it will help first sleeping at night take one or two of them if you need but if it’s not that matter in the day you don’t have to now here we are a week later and the lesions are almost completely imperceptible you can still see fairly where there’s a little crust which actually looks pretty classic for when somebody’s had shingles the good news is the the pain is completely gone yeah completely God and I would attribute that to using the antiviral the valacyclovir which does if you get it within a couple days does help to clear up and helps you keep from post herpetic neuralgia which is where after having an infection with a herpesvirus like herpes zoster in this case it continues to hurt her and that didn’t happen thankfully for you right the only thing I was feeling was around the top of my head just the top and now it’s fine you can touch it if not not heard no okay so that’s a successful treatment of herpes zoster or shingles are pretty sure that’s what it is now based on its response to the antiviral and the appearance of the skin now with those little yellow crust whether used to be what weren’t true vesicles they were actually fluid-filled but you did see some ok yeah so that’s another successful treatment hey thanks for joining us if you like medical procedures go ahead and click here to see some more videos and if you have already subscribed please click over here or over here to subscribe until next time this is richard and dr.
mark on telling you to stay good help.