Herpes zoster opthalmicus Dermatology ppt

Herpes zoster opthalmicus - case presentation

1. CASE PRESENTATION:                 HERPES ZOSTER OPHTHALMICUS PRESENTER: G.VARSHA. DATE: 12 th Aug,2025. AIIMS BIBINAGAR.

2. PATIENT PROFILE: NAME: G.KAVITHA AGE: 41-YRS SEX: FEMALE ADDRESS: MEERPET PRESENTATION DATE: 04/08/2025

3. CHIEF COMPLAINTS   :   Pain, Redness, rashes Over Right side of the Cheek, nose ,upper lip since 6days Redness , swelling, Tearing pain In Right Eye since 2 days.  Blurred Vision Since 2 Days.

4. HISTORY OF PRESENT ILLNESS: DAY-1: Patient Was Apparently Normal 6 Days Back Then She Developed Tingling And Burning Sensation Over The Right Side Of The Face Followed By Appearance Of few Fluid Filled lesions First Seen On Right Side Of The Nose and upper lip.

5. DAY-2 TO 4: Multiple Fluid Filled lesions Progressing To Right Cheek, Right Lower Eye Lid, Right Side Of Nose And Right Upper Lip. Vesicles Begin To Crust. Pain In The Affected Area Intensifies. The Patient Developed Edema Over The Right Upper Eyelid, Along With Edema Of Both The Upper And Lower Lips. Day-2 Day-3 Day-4

6. DAY-5 TO 7: The Lesions Showed Persistent Crusting, With The Subsequent Development Of Erosions Day-5 Day-6 Day-7

7. H/O Drug Intake For Rheumatoid Arthritis(METHOTREXATE 15 mg) . NO H/O INSECT BITE. No H/O Fever.  No H/O Diarrhea. No H/O malaise . No H/O Contact with herpes zoster cases.

8. PAST HISTORY : No H/O Similar Complaints In The Past . No H/O Diabetes , Hypertension, Asthma, CKD, CAD. No H/O Chicken Pox. The Patient Has A Two-year History Of Rheumatoid Arthritis, For Which She Received Homeopathy Treatment for two years. She Subsequently Consulted The Department Of Physical Medicine And Rehabilitation for joint pains Where She Was Prescribed Methotrexate 15 Mg Along With Folic Acid 5 Mg. She Took One Dose Of Methotrexate.

9. PERSONAL HISTORY  Diet - Mixed Appetite – Normal Sleep – Adequate Bowel And Bladder Habits Regular No Substance Use Disorder.

10. FAMILY HISTORY: No Similar Complaints In The Family. MENSTRUAL HISTORY: Regular Cycles ,3/30. OBSTETRIC HISTORY: P 1 L 1 Normal Vaginal Delivery

11. GENERAL EXAMINATION   ON EXAMINATION: Patient Conscious, Alert ,Oriented To Time, place, person. No Pallor No Icterus No Cyanosis No Clubbing No Pedal Edema

12. MUCOCUTANEOUS EXAMINATION SKIN AND APPENDAGES: FACE- Multiple Vesicles and bullae With Erythematous Base Noted On Right Side Of The Face Involving Right Lower Eye Lid, Cheek, Nose, Upper Lip. Sparing Left Side Of The Face. Crusting Present over upper lip. Serosanguineous discharge present. PALMS AND SOLES : spared HAIR AND NAILS : Normal

13. ORAL CAVITY : Erosions Noted On Hard Palate ,Buccal Mucosa, upper Lip, Oedema Of Upper Lip With Crusting Present. EROSIONS SEEN ON THE RIGHT SIDE OF THE PALATE SPARING LEFT SIDE

14. EYELIDS : Upper Eyelid Edema +,Lower Eyelid Crusting. CONJUCTIVA : Edematous NASAL MUCOSA : Normal GENITALIA : Normal RECTAL MUCOSA : Normal

15. MANAGEMENT INVESTIGATIONS LAB INVESTIGATIONS : CBC: HB: 10.9g/dl WBC: 6.03 10^3/µL PLT: 150 10^3/µL VIRAL MARKERS: HIV: NON-REACTIVE HBV,HCV: NON-REACTIVE CUE: With in Normal limits BED SIDE –TZANCK SMEAR LAB INVESTGATIONS

16. DIAGNOSIS : HERPES ZOSTER OPHTHALMICUS IN-HOSPITAL TREATMENT CONSERVATIVE MANAGEMENT: ISOLATION. STAY AWAY FROM CHILDREN SALINE SOAKS MEDICATION: T VALCYCLOVIR: 1gm tid For 7-days FUDIC ACID CREAM TWICE DIALY APPLICATION T ATARAX 10mg OD T PCM 500mg BD LUBREX EYE DROPS

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