Clinical practice: Herpes zoster

Abstract

A 65-year-old man presents with a rash of 2 days duration over the right forehead with vesicles and pustules, a few lesions on the right side and tip of the nose, and slight blurring in the right eye. The rash was preceded by tingling in the area and is now associated with aching pain. How should this patient be evaluated and treated?

Conflict of interest statement

The views expressed here are those of the author and not necessarily those of US government.

No potential conflict of interest relevant to this article was reported. Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Figures

Figure 1

(A) Zoster in the ophthalmic (V1) branch of the trigeminal ganglia. Photograph courtesy of Michael Oxman, M.D. (B) Vesicles and pustules in a patient with zoster. These are representative photographs and are not from the case presented.