Case study ( 1927 views as of December 16, 2017 )
Sasha is a 47-year-old receptionist at an accounting firm. It has been very busy and high pressure lately at work, and in the last week she has felt like she 'might be coming down with something'. She has had body aches, and feels tired and run down. Yesterday morning, Sasha noticed irritation on the left side of her back, and wondered if she was suffering irritation caused by her bra strap. Today, she notes an expanding, painful rash across the left side of her back, and around the side of her chest. A few spots are also present on the underside of her left breast. She cannot comfortably wear her bra, and feels quite a bit of pain even with the fabric of her shirt rubbing against the rash.
Sasha should have this rash assessed by her primary care provider. Rashes such as this may be due to a viral re-activation of the chicken pox virus, and is called 'Shingles'. This rash typically shows up on one side of the body, and follows a stripe of skin associated with a single nerve distribution from one level of the spine, also known as a dermatome. Early diagnosis is important, as anti-viral medications are of minimal use after 24-48 hours of the rash. Steroid medication may play a role in some cases.
Complications of shingles may include nerve pain in that same distribution that may last much longer than the visible rash on the skin. While the contagious risk is much less than a primary outbreak of chicken pox, patients with shingles are advised to avoid direct contact with anyone who is, or is trying to become, pregnant.Author: Dr. Adam Lund