Skill Checkup: A 58-Year-Old Vaccinated Man With a Painful, Itchy Rash on His Face and Trunk

Heidi Moawad, MD


May 08, 2023

Antiviral therapy has been shown to ease symptoms of acute HZ by decreasing the time to new vesicle formation, hastening the resolution of lesions and reducing the number of days of acute discomfort. Antiviral therapy can also help prevent post-herpetic neuralgia, especially in older patients. A choice of three antivirals may be used to treat HZ: acyclovir 800 mg, five times daily for 5 days, valacyclovir 1 gm, three times daily for 5 days and famciclovir 500 mg, three times daily for 7 days.

Laboratory testing to confirm diagnosis is not necessary except in select patients or in cases of uncertainty, particularly those who are immunocompromised. Because this patient is not immunocompromised, laboratory testing has no utility.

NSAIDs and calamine lotion are considered symptomatic, conservative therapies and do not affect the underlying condition.

Given the extent of this patients' symptoms, he and his physician agree to a prescription of acyclovir 800 mg, five times daily for 5 days.


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