Chickenpox or scabies on this adult? (Internal Medicine)

Dr. Muhammad Zubayer Alam
Pulmonologist

HI,thnx for medical case review.according to the statement and the pictures that r provided here,I think it may be a case of Shingels which is a viral infection caused Vericella Zoster-the same virus that cause chicken pox.the Shingles rash can be clusters of fluid filled blisters-often in a band around one side of the waist.the rash may also appear around chest,upper back,face,the limbs,neck or upper back.
if someone ever had the the chickenpox -and almost all adults have or have at least
exposed to it-there is a good chance the virus is still at large in body.the virus can lie dormant for decades without causing any symptoms.
along with Calamine antviral medications like acyclovir(Zovirax),famciclovir(Famvir), Valacyclovir(Valtrex) etc;antihistamin for itching;corticosteroid for reducing inflammation;painkiller for pain relief can be used according to severity.

Dr. Albana Greca
General Practitioner

Thank you Dr. Zubayeralam

I was thinking to start antiviral, thank you again for reassuring.

All the best.

Dr. Muhammad Zubayer Alam
Pulmonologist

Thank u too. it's my pleasure.u r always welcome.

Dr. Nadeem Abootty
Diabetologist

Hi
from your pictures it's not showing a segmental vesicles ( in a single dermatomal distribution) which is characteristic of herpes zoster ...so I don't feel it's herpes zoster.
it can be varicella(chicken pox) which can be distributed in this manner,but the picture is not clearly vesicles..may be broken vesicles.
in first look itseems chicken pox for me.
and also I was confused with what you have mentioned,that it was first noticed 1month bak

Dr. C. Elanchezhian
General Medicine Physician

Hello Dr.
This a case of chicken pox.
Scabies lesions mostly in between fingers interdigital areas.
Yes anti viral drugs and calamine lotion is the preferable treatment with anti histamines.

Dr. Waseem Ahmed. N
Diabetologist

Hi Dr. Albana,
With the history that it occured 1 month back as well, the clinical suspicion is towards reactivation of previous chicken pox probably.
Can definitely go ahead with anti viral therapy and other supportive measures.

Dr. Albana Greca
General Practitioner

Thank you Dr. Nadeem Abootty, Dr. C Elanchezhian, Dr. Waseem Ahmed N for all your input.
Yes, the itching lesions started 1 month back, but the patient was only today in my clinic. I will get a recheck in a week time.

Thank you again to all of you.

Dr. Waseem Ahmed. N
Diabetologist

Rule out insect bite.
I understand that you mean the lesions are there since 1 month.
Unlikely to be chickenpox then.
Focus on clean Living environment. Clothes/sheets dried well under sunlight.
Support with antihistamine and topical mild potency steroid. Should help hopefully.

I also request for a detailed history next time onwards.

Dr. Muhammad Zubayer Alam
Pulmonologist

Hello
sorry for disturbing u.I want to know the diagnosis of that patient.can u provide her final diagnosis here?have a nice day.

Dr. Albana Greca
General Practitioner

Hello

Lesions cleared with calamine and antihistamines and 5 days of starting a aciclovir.

It was chicken pox reactivation.

Thank you for your input. Good day to all.