Brief Answer: clinical review, circumstances, herpes to be exclu Detailed Answer: Hi and thanks for the query, It is of utmost importance to evaluate the conditions surrounding this pain and the rash. If the rash only comes when there is pain, and always when there is pain, it is fundamental to ascertain the cause of the pain. Generally, if its of viral origin, it would not be surprising to have an associated rash. The characteristics of the rash are as well important. The specific area it occupies, the spread, evolution with or without treatment. In case only specific regions are touched, and especially if there is pain, it would probably be resurgence of Herpes virus infection. A proper clinical review is required. Checking of the immune system, specifics of the rash, exclusion of herpes infections are in my opinion, the first initial steps. Thanks and kind regards as I wish you the best of health. Please, do feel free asking any further questions for clarification in case of need. I would be honored making my humble contribution. Thanks and kind regards Dr Bain

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Brief Answer: Need urgent evaluation especially if appendicitis Detailed Answer: Hi and thanks for the update. It might be very important to get to know what is causing the pain exactly. I do think appendicitis does have other accompanying signs and symptoms like a characteristic right lower abdominal pain, nausea, at times vomiting, fever, raised white blood cell count when a complete blood count is done and raised makers of inflammation. It might be necessary for an abdominal ultrasound to be done. Appendicitis is an emergency and should be treated as such. The opinion of your emergency physician could be very helpful. This is to avoid any complications that might arise such as perforation (peritonitis). I do understand it might be difficult , but I do believe its urgent to get an urgent evaluation to ascertain the origin of this pain. An abdominal CT scan and ultrasound, clinical examination, blood tests like complete blood count and C reactive protein for inflammation could be very useful. Kind regards as I wish you the best of health. Dr Bain

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