Main menu
Common skin conditions
NEWS
Check out what's new with DermNet
Read more
Quick links
For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately five minutes to complete. There is a list of suggested further reading material at the end of the quiz.
When you finish the quiz, you can download a certificate.
What is the diagnosis?
She has Herpes zoster. The presentation of localised pain, malaise and rash is characteristic, but is surprisingly often misdiagnosed. There are small grouped vesicles on an inflamed base in a dermatomal distribution.
What investigations should be performed?
No investigations are necessary in most patients as the diagnosis is made clinically. In doubtful or unusual cases, herpes zoster can be confirmed by tissue culture of scrapings from a de-roofed blister.
What management should you recommend?
Treatment guidelines in the Pharmaceutical Schedule recommend oral aciclovir 800mg daily five times daily for seven days in the following circumstances:
Valaciclovir and famciclovir are no longer available in New Zealand.
In addition, analgesics such as paracetamol, codeine phosphate, narcotics or amitripytline/nortripyline may be prescribed. Soothing antiseptic topical applications may be helpful.
The use of systemic corticosteroids is controversial and is not currently recommended.