Herpes Zoster

Question 1

Causative?

Answer 1

Reactivation of VZV virus i.e. Chickenpox virus lying latent in posterior root ganglion of a spinal nerve

Question 2

Commonly involved nerves?

Answer 2

Thoracic nerves ( intercostal nerves)
Ophthalmic division of trigeminal nerve
Spinal nerves

Question 3

Pathology?

Answer 3

Ballooning - is characteristic
On Tzanck smear - multinucleated giant cells

Question 4

Mc involved dermatome?

Answer 4

T3 to L3

Question 5

Presentation?

Answer 5

Segmental pain begins 1-4 days before eruption → erythema & edama → U/L grouped vesicles a/w severe pain

Question 6

What is post herpetic neuralgia?

Answer 6

Its a complication of herpes zoster
Persistent neuralgic pain
Mc after involvement of trigeminal region →rx is capsaicin patch, oral amitryptyline, gabapentin, duloxetine

Question 7

Which division is involved in herpes zoster opthalmicus?
What is Hutchinson’s sign?

Answer 7

Ophthalmic division of trigeminal nerve
Eye (corneal ulcer) involvement is indicated when vesicles are present on the tip of nose → Hutchinson’s sign

Question 8

What is Ramsay hunt syndrome?

Answer 8

Aka → herpes zoster oticus → involve geniculate ganglions of sensory branch of facial nerve

Question 9

How can lesions of smallpox & chickenpox be differentiated ?

Answer 9

Smallpox → lesions in any given area are at the same stage of development
→ there is prominent distribution of lesions on face & extremities, including palms & soles

Question 10

Chickenpox lesions?

Answer 10

Lesions include maculopapules, vesicles & scabs in various stages of evolution