Skill Checkup: A 40-Year-Old Woman With Rheumatoid Arthritis Has Fever, Headache, Photophobia and Painful, Burning Rash

Heidi Moawad, MD


May 08, 2023

Patients who are immunocompromised and present with HZ before all lesions have crusted over, like this patient, should receive antiviral therapy. Antiviral treatments like oral acyclovir have been shown to stop disease progression and the dissemination of acute HZ in patients who are immunocompromised. IV acyclovir is indicated for patients who are immunosuppressed and have evidence of disseminated disease, visceral organ involvement or ophthalmic involvement.

Because this patient does not present with these complications, the patient and physician agree to a course of oral acyclovir, continuing until all lesions have resolved.


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