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Suggest Treatment For Recurrent Bouts Of Shingles
Question: Hi. I am a 42 year old female. About nine years ago I had my first attack of singles. One year ago my second attack, and since the beginning of May I have had TWO more attacks. The shingles started on my face and then ended up on my right breast at the beginning of May. The Valtrex cleared them up very quickly so I went on suppressive therapy but now they are back again despite the therapy with Valtrex. They are on my face again! They are leaving deep dark scars. WHY AM I HAVING SO MANY SHINGLES ATTACKS?? Why is the Valtrex not working to prevent the attacks? I am having surgery on Thur and I wonder if this will worsen anything. Am I going to have to deal with these attacks being so close together for the rest of my life? Please help!
Brief Answer:
Kindly upload a few Images
Detailed Answer:
Hello. Thank you for writing back to us.
I have gone through your query and I understand that you are concerned about recurrent bouts of possible shingles.
It is very unusual to have so closely spaced and recurrent attacks of shingles unless there is an underlying immunosuppressive illness.
I would like to ask you whether these episodes were confirmed as Shingles by a medical professional??
I would like to request you to upload a few representative images of skin lesions so that I am able to confirm whether it is actually shingles or it is something else.
You may upload an Image either at "Reports Section"
Or
You may also mail me the Images at YYYY@YYYY with the subject line of this mail as Attn:Dr. Kakkar.
Regards
Kindly upload a few Images
Detailed Answer:
Hello. Thank you for writing back to us.
I have gone through your query and I understand that you are concerned about recurrent bouts of possible shingles.
It is very unusual to have so closely spaced and recurrent attacks of shingles unless there is an underlying immunosuppressive illness.
I would like to ask you whether these episodes were confirmed as Shingles by a medical professional??
I would like to request you to upload a few representative images of skin lesions so that I am able to confirm whether it is actually shingles or it is something else.
You may upload an Image either at "Reports Section"
Or
You may also mail me the Images at YYYY@YYYY with the subject line of this mail as Attn:Dr. Kakkar.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
I have sent a picture of the last outbreak that was on my breast and the current outbreak on my face.
Yes, I did have the diagnosis confirmed by a doctor at a local Med Express. I have not been to the doctor this time as they have just resurfaced today.
I am diabetic but it is controlled relatively well my last A1c was 6.8. Once my A1c was 8.1 many years ago but I otherwise it is relatively controlled.
Yes, I did have the diagnosis confirmed by a doctor at a local Med Express. I have not been to the doctor this time as they have just resurfaced today.
I am diabetic but it is controlled relatively well my last A1c was 6.8. Once my A1c was 8.1 many years ago but I otherwise it is relatively controlled.
Brief Answer:
I seriously doubt the diagnosis of Shingles.
Detailed Answer:
Hi.
Thank you. I have reviewed the Images. The images are not very clear to me. I would have preferred better resolution Images.
I would like to make a few important points here...
First of all, I would like to tell you that there is no such thing as Suppressive Therapy in Herpes Zoster!!
Shingles is only treated as an epsiode i.e with not more than 7-10 days of antivirals.
Secondly, Herpes zoster does not recur so frequently in a space of a few days without any history of immunosuppression.
Moreover Shingles has a dermatomal distribution i.e in a stripe like pattern along the sensory nerve supply of dermatome.
It is not likely that a Shingles episode would involve such widely spaced dermatomes i.e face and breast simultaneously.
I would like you to review this diagnosis with a dermatologist.
-I wish to help you more if you can upload better quality Images.. clear and focused Images in good light.
-I would also like to know whether there are any symptoms like burning sensation, pain etc? Shingles is usually painful.
-Is it only on one side of the body Or is it on both sides? Shingles is always unilateral.
Regards
I seriously doubt the diagnosis of Shingles.
Detailed Answer:
Hi.
Thank you. I have reviewed the Images. The images are not very clear to me. I would have preferred better resolution Images.
I would like to make a few important points here...
First of all, I would like to tell you that there is no such thing as Suppressive Therapy in Herpes Zoster!!
Shingles is only treated as an epsiode i.e with not more than 7-10 days of antivirals.
Secondly, Herpes zoster does not recur so frequently in a space of a few days without any history of immunosuppression.
Moreover Shingles has a dermatomal distribution i.e in a stripe like pattern along the sensory nerve supply of dermatome.
It is not likely that a Shingles episode would involve such widely spaced dermatomes i.e face and breast simultaneously.
I would like you to review this diagnosis with a dermatologist.
-I wish to help you more if you can upload better quality Images.. clear and focused Images in good light.
-I would also like to know whether there are any symptoms like burning sensation, pain etc? Shingles is usually painful.
-Is it only on one side of the body Or is it on both sides? Shingles is always unilateral.
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I don't have any clearer images that what i sent you. The one that was taken on the breast is the only one I have. Can't shingles occur anywhere on the body? That picture was taken when I had shingles last month and of course, they have cleared up by now. I understand you are saying this is not shingles but every time I've had shingles I did have the shingles confirmed by a doctor, except this time when they are on my face. Last month when they were on my breast, they were on my face (on my chin) and the doctor confirmed the diagnosis then as well. When I took the Valtrex (and a steroid, acyclovir cream, and gabapentin) they healed up within a few days so I assume the diagnosis was correct. I guess it is possible the doctor didn't know what he was talking about but the medication worked. This was a doctor at a local med express and the other two times I had shingles, the doctor was my GP. The first time I waited a week before seeing a doctor. He told me it has been too long and would not give me an antiviral so I had to wait for the rash to clear up. I do have pictures of that outbreak as well, somewhere, but that was nine years ago.
Yes, I was in extreme pain when I had shingles, there was burning, stabbing pains and clothes even touching my skin was painful. I could not wear a bra. Yes, every time I've had shingles, it has been on one side of the body.
I had extra acyclovir cream left over from last month so I put it on my face and whatever the rash, shingles or not, is clearing up.
I will make sure if this rash ever appears to see a dermatologist and not a GP or the doctor at the local med express.
I do not have any other conditions that would weaken my immune system except diabetes.
Thank you.
Yes, I was in extreme pain when I had shingles, there was burning, stabbing pains and clothes even touching my skin was painful. I could not wear a bra. Yes, every time I've had shingles, it has been on one side of the body.
I had extra acyclovir cream left over from last month so I put it on my face and whatever the rash, shingles or not, is clearing up.
I will make sure if this rash ever appears to see a dermatologist and not a GP or the doctor at the local med express.
I do not have any other conditions that would weaken my immune system except diabetes.
Thank you.
Brief Answer:
I suggest that you get a confirmation with a dermatologist
Detailed Answer:
Hi.
Shingles can appear anywhere on the body i.e on face, chest etc and it follows a dermatomal pattern i.e horizontal stripes of red, painful, vesicular rashes.
It is painful with burning and stanning pains and after going through your history I assume that at least one or two of the episodes that you had were shingles but I am not sure whether all of them Or the present one is also shingles.
It is very unsual to have 3 episodes of shingles in short span to time unless there is an underlying immunosuppression e.g HIV or other immunosuppressive illnesses. Diabetes, if well controlled cannot be an explanation for recurrent shingles
I suggest that you visit a dermatologist for a confirmatory diagnosis.
Regards.
I suggest that you get a confirmation with a dermatologist
Detailed Answer:
Hi.
Shingles can appear anywhere on the body i.e on face, chest etc and it follows a dermatomal pattern i.e horizontal stripes of red, painful, vesicular rashes.
It is painful with burning and stanning pains and after going through your history I assume that at least one or two of the episodes that you had were shingles but I am not sure whether all of them Or the present one is also shingles.
It is very unsual to have 3 episodes of shingles in short span to time unless there is an underlying immunosuppression e.g HIV or other immunosuppressive illnesses. Diabetes, if well controlled cannot be an explanation for recurrent shingles
I suggest that you visit a dermatologist for a confirmatory diagnosis.
Regards.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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