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Q. What could be the cause of blisters with surrounding redness in the skin?

Answered by
Dr. Ashwini V Swamy
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 12, 2018

Hello doctor,

I am inquiring about a small group of rashes that appeared about a week ago and have not changed much. They are small clusters of raised bumps that are slightly itchy. It aches with movement and aggravated when touched. Please help.

#

Hi,

Welcome to icliniq.com.

I saw your picture (attachment removed to protect patient identity). There are few papulovesicles (few are solid bumps, few blisters as per the picture) arranged in groups, with erythema (redness) at the base involving the right side of the chest. Features are consistent with herpes zoster, more of abortive variety because you are saying it is not progressing and staying same since a week.

Herpes zoster is also called shingles. It is the reactivation of virus varicella, which causes chickenpox usually in children. It starts with pain, burning sensation involving one half of the body limiting to one dermatome (body is divided into different dermatome). Later, there will be painful blisters in groups in a linear fashion. It has to be treated with antiviral medicine (Acyclovir or Valacyclovir) as early as possible.

Other possibilities are:

  1. Poison ivy.
  2. Irritant contact dermatitis.
  3. Insect bite reaction.

Please fill in this information to rule out these possibilities and confirm the diagnosis. Do you have similar red bumps on the right side of back? Please check your upper back, armpits, and arm. Any history of physical stress, illness, surgery, any crash diet, vigorous exercise (outdoor play/activity) or injury in the recent past? Are you using any oral medication or any recent history of travel?

Revert with more information to a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

I also think that my symptoms are consistent with this diagnosis (shingles). In the past two weeks, I have received a large tattoo and lifted weights vigorously five or more times and also played indoor soccer two or more times. And my first ever hot yoga session was held and had interpersonal stressors arise.

I do have another patch, about a size of a nickel on the backside of the torso in the similar area. Armpit area is also sore. No recent travel or outdoor activity.

#

Hi,

Welcome back to icliniq.com.

Thank you so much for your kind words. The presence of blisters in groups with surrounding redness distributed along a dermatome confirms the diagnosis of herpes zoster/shingles.

Herpes zoster has to be treated as early as possible to prevent postherpetic neuralgia, which is nerve pain.

Treatment includes:

  1. Oral Acyclovir 800 mg five times a day for five days. Take one pill at an interval of three to four hours after food or Oral Valacyclovir 1 g three times a day for five days. Take one pill at an interval of eight hours after food. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent.
  2. Topical Calamine lotion to soothe the skin, apply two times a day.
  3. Oral Paracetamol, 500 mg two times a day after food or oral Ultracet tablet which is the combination of Tramadol 37.5 mg and Acetaminophen 325 mg (if the pain is severe), two times a day after food.

Please start the antiviral tablets as soon as possible and limit physical activity for another three to five days. Use a mild soap to take bath. Drink two to three liters of water per day. Expect the blisters to be gone in another three to four days. Take care, wish you a speedy recovery.

For further queries consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

When can I expect the physical fatigue to wear off? If I do the Acyclovir only then will I be alright? I do not think I need pain medication, although it is painful. I plan on just supplementing with Ibuprofen. Is that acceptable? Also, they never appeared to open, and have scabbed up. Very small little things. You think three to four days and it will clear up? Thanks again doctor.

#

Hi,

Welcome back to icliniq.com.

Physical fatigue may last for another week. Acyclovir is good enough if you feel you can bear with the pain, but take the right dose (800 mg) for the right duration (five times a day for five days) as I have mentioned earlier. Ibuprofen is equally effective as Paracetamol.

Scabs indicate resolution phase. It should clear up in three to four days. You can also apply any good moisturizer like Cetaphil or Eucerine just to keep the area moist. That helps faster healing. Eucerine has ceramide, it helps to restore the skin barrier faster.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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