Question

Which of the following is most consistent with the diagnosis of herpes zoster?

Papules in a dermatomal distribution
Low-grade fever and malaise prior to eruption
Presence of pustules and honey-crusted lesions
A 1-2-day prodrome of pain prior to lesions erupting

Answer 1

Pain preceding the appearance of skin lesions is most consistent with herpes zoster. Known commonly as shingles, this condition involves a painful rash and can be treated with antiviral medication like acyclovir to manage symptoms and prevent complications such as long-term neuralgia.

Step-by-step explanation:

The diagnosis most consistent with herpes zoster (shingles) is a 1-2-day prodrome of pain prior to lesions erupting.

Herpes zoster often presents with a prodromal period of pain, tingling, or itching in a dermatomal distribution followed by the appearance of clustered red papules that progress to vesicles and then pustules, which may become encrusted.

Along with these skin lesions, some patients may experience low-grade fever and malaise before the rash appears.

Once reactivated, the varicella-zoster virus, which is responsible for both chickenpox in children and shingles in adults, travels along sensory nerves to the skin causing these painful lesions.

Treatment can include antiviral medications like acyclovir to reduce severity and the risk of complications such as postherpetic neuralgia.

Answer 2

A 1-2-day prodrome of pain before eruption of lesions, is most indicative of herpes zoster, and papules usually present in a dermatomal pattern.

Step-by-step explanation:

The most consistent presentation for a diagnosis of herpes zoster, commonly known as shingles, is a 1-2-day prodrome of pain prior to the lesions erupting. This pain is typically followed by the development of papules in a dermatomal distribution. Patients may also experience low-grade fever and malaise before the lesion eruption, but the presence of pustules and honey-crusted lesions is more characteristic of impetigo. While herpes zoster can sometimes lead to the formation of pustular vesicles, these occur as the lesions progress, and the initial description of pain followed by a dermatomal rash is more specific to shingles.