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

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?

I hope this helps.

Thank you.

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.

I hope this helps.

Thank you.

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.

I hope this helps.

Thank you.