Dermatology

Shingles (Herpes Zoster): Or something else? Differential Diagnosis

Infectious and parasitic diseases (A00-B99). Infections with other viruses, such as herpes simplex virus or coxsackieviruses. Musculoskeletal system and connective tissue (M00-M99). Arteritis temporalis (synonyms: Arteriitis cranialis; Horton’s disease; giant cell arteritis; Horton-Magath-Brown syndrome) – systemic vasculitis (vascular inflammation) affecting the arteriae temporales (temporal arteries), especially in the elderly. Psyche – nervous system (F00-F99; G00-G99). … Shingles (Herpes Zoster): Or something else? Differential Diagnosis

Shingles (Herpes Zoster): Complications

The following are the most important diseases or complications that can be caused by herpes zoster (shingles): Respiratory system (J00-J99) Pneumonia (pneumonia)/pneumonitis (esp. in immunosuppressed patients) – Note: typical skin changes show up only with a long latency of up to 14 days. Eyes and eye appendages (H00-H59). Zoster ophthalmicus (affects 10-20% of adult zoster … Shingles (Herpes Zoster): Complications

Shingles (Herpes Zoster): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye) rash with formation of vesicles (zoster vesicles; also possible without efflorescence) in the affected dermatome/skin area, … Shingles (Herpes Zoster): Examination

Shingles (Herpes Zoster): Test and Diagnosis

The diagnosis is usually made clinically. 2nd order laboratory parameters – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification. Direct virus detection using PCR (polymerase chain reaction) from vesicle contents, skin biopsies, cerebrospinal fluid* , or blood – for detection of varicella zoster virus infection [sensitivity and specificity … Shingles (Herpes Zoster): Test and Diagnosis

Polymorphous Light Dermatosis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin [patchy erythema (areal redness of skin), followed by: bullae (blisters), papules (vesicles), papulo-vesicles (mixture of papule and vesicle (vesicle)), plaques] Predilection sites (typical sites for the appearance of … Polymorphous Light Dermatosis: Examination

Shingles (Herpes Zoster): Drug Therapy

Therapeutic targets Shortening the symptomatic phase Avoidance of complications Therapy recommendations Antiviral therapy: as soon as possible: virostasis (antivirals/drugs that inhibit viral replication)Note: Antiviral therapy within 72 hours of vesicle breakdown also reduces the risk of postzoster neuralgia.First-line therapy: Patients <50 years + limited findings on trunk and extremities: Antivirals (aciclovir, brivudine, valaciclovir, and famciclovir), … Shingles (Herpes Zoster): Drug Therapy

Shingles (Herpes Zoster): Diagnostic Tests

Diagnosis is usually made on the basis of history and physical examination. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnosis in case of complications. Computed tomography of the skull (cranial CT, cranial CT or cCT) – if meningoencephalitis … Shingles (Herpes Zoster): Diagnostic Tests

Polymorphous Light Dermatosis: Drug Therapy

Therapeutic target Alleviation of symptoms Therapy recommendations Beta-carotene Nicotinamide and folic acid Corticosteroids; azathioprine in extreme individual cases. Antihistamines can relieve the itching See also under “Further therapy“. All agents have in common a relatively limited efficacy. In experimental studies, efficacy has been demonstrated for E. coli extract. Supplements (dietary supplements; vital substances) Appropriate dietary … Polymorphous Light Dermatosis: Drug Therapy