NSG 550 response 12

Discussion 12

  • The likely diagnosis for this 65-year-old man is shingles, otherwise known as herpes zoster viral infection. Varicella zoster virus reactivation results in the secondary illness known as shingles, which affects nearby nerves and skin. (Sly & Harris, 2018). The dermatomal rash is typically unpleasant yet self-limiting accompanied by pain along the afflicted dermatome, which is usually the first symptom, followed in 2–3 days by a vesicular eruption(Janniger, 2021).
    Clinical presentation can be grouped into three stages: preeruptive phase, acute eruptive phase, and the chronic phase. Early signs and symptoms include:

    Tingling or burning where the lesions are
    fever
    headache
    myalgia
    malaise (Sly & Harris, 2018)
    The acute eruptive phase consists of:
    development of painful rash
    tingling in the vicinity of the injured nerve
    fluid filled blisters arise
    blisters that were liquid-filled rupture and crust in 7-10 days (Shingles (Herpes Zoster), 2021)
    The history and physical findings are the main factors used to make a diagnosis. In immunocompromised patients, labwork may be ordered such as:
    vesicular fluid or a corneal lesion being tested with direct fluorescent antibodies (DFA)
    polymerase chain reaction (PCR) of blood, vesicular fluid, or a corneal lesion
    vesicular fluid tzanck smear (Janniger, 2021)
    Differential Diagnoses include:
    Acne Keloidalis Nuchae (AKN)
    acneiform Eruptions
    allergic Contact Dermatitis
    cellulitis
    chickenpox
    dermatologic Manifestations of Herpes Simplex
    acneiform Eruptions
    insect Bites (Janniger, 2021)
    Antivirals are employed in the treatment of shingles to lessen the duration and intensity of the condition. They ought to be started as soon as the rash shows for the best outcomes. These drugs include acyclovir, valacyclovir, and famciclovir as examples (Shingles (Herpes Zoster), 2021). 

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    References
    Janniger, C. K. (2021, August 21). Herpes Zoster. Medscape. https://emedicine.medscape.com/article/1132465-overview
    Shingles (Herpes Zoster). (2021). CDC. https://www.cdc.gov/shingles/index.html
    Sly, J. R., & Harris, A. L. (2018). Recombinant zoster vaccine (shingrix) to prevent herpes zoster. Nursing for Women’s Health, 22(5), 417–422. https://doi.org/10.1016/j.nwh.2018.07.004

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