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Name
: Tn. Syarifuddin
Sex
: Male
Age
: 64th years old
Address
: Makassar
Status
: Married
Religion
: Islam
Diagnosis
: Herpes Zooster Cervicothoracalis
(C4-C6, T1-T8)
CASE STUDY
Anamnesis
CHIEF COMPLAINT: PAIN ON THE UPPER RIGHT ARM
ANAMNESIS TERPIMPIN: A patient come to the hospital with a
chief complain of a pain sensation on his body since 3 days he
came to the hospital. He felt the pain on his upper right arm and
spread to his chest and back. The pain felt like a stabbing sensation
take place through out the whole day. The pain is felt for three days
and then red spots appeared on the upper right arm, spread to his
chest and back. The red spots then turn to vesicles when he was
being treated at the hospital.
Vital Signs:
Blood Pressure
Respiration Rate
Heart Rate
Temperature
Consousness
: 130/90mmHg
: 24kali/menit
: 70 kali/menit
: 36,7c
:Compos Mentis
Dermatology Status
Regio: Regio truncus anterior et
posterior dextra, regio brachialis
dextra
Clinical Lession: vesikel
berkelompok dengan dasar eritem,
bulla
Before Treatment
After Treatment
Dermatologist Therapy
WHAT IS HERPES
ZOSTER ?
EPIDEMIOLOGY
ETIOLOGY
PATHOGENESIS
Headache
Photophobia
Malaise
Unbearable itching
Pain (varying severity)
Aching
Burning
Stabbing
Shock-like
Provoked by trivial
stimuli
Altered sensitivity to
touch
LESION
Usually limited to 1 or
2 adjacent, unilateral
dermatomes1,2
Grape-like lesions
clustered on an
erythematous base1,2
Lesions usually heal
within 4 weeks1
DIAGNOSIS
History taking
Physical examination
Laboratory examination
EXAMINATION
Tzank smear
histopathological
culture
PCR
serological
DIFFERENTIAL DIAGNOSIS
Herpes simpleks
-Vesicles
-Burn sensation
-Pain
-Itchy
Allergic Contact
Dermatitis
-Vesicles
-Erosion
-In chronic lesion: dry,
lichenification, papul
MANAGEMENT
Anti-Viral
Normal
Age <50 year
Age> 50 years and
accompanied by
lesions of herpes
zoster in the
ophthalmic
Simptomatic therapy or
Famciclovir 3 x 500 mg --7 days
Valacyclovir 3 x 1000 mg -- 7 days
Acyclovir 5 x 800 mg -- 7 days
Immunocompromised
infection
Acyclovir resistance
PROGNOSIS
Dubia ad Bonam
If treated early, post herpetic neuralgia can be avoided
Thank you