Monday, February 14, 2011

One-sided acute rash on face

H complains of a blistering rash that affected only one side of his face. It resolved in about a week.

Notice a few things about this rash - it occurs on one specific area, not crossing the midline; the rash appears as separate islands; each island comprises of small blisters (some broken from scratching). This is shingles, or "snake" as what the older generation would say. It is due to the reactivation of the chickenpox virus due to some acute illness (which transiently lowers the body immune system so that the virus takes the opportunity to ''reactivate"), but sometimes it can occur spontaneously. The reactivated virus can run along any nerve root on one side of the body (in this case, it's along the mandibular division of the left trigeminal nerve). The appropriate treatment would be a course of oral anti-viral medication. Now, the skin can also heal without this medication, but the medication helps to hasten recovery! One should also keep the skin clean so as to reduce the chance of a bacterial super-infection. Some older folks can get a bothersome pain on the affected area after healing of the rash; they will need to see a doctor for some special nerve medication to control it...