Painful Rash in Back - Could it be Shingles?

Patient

Q: I have a rash on the left side of my back, it hurts, itch's all the time, has blisters. it extends from the middle of my back and goes straight across to my left arm pit and on the front of my left breast. I have pain in my chest on the left side, it doesn't hurt when I breath, its a stabbing pain,could this be part of the shingles?

Doctor

A:   Herpes zoster, also called shingles, is a reactivation of the varicella-zoster virus (VZV) that causes chickenpox. The varicella-zoster virus lies dormant in the spinal nerve roots or ganglion until a decrease in cellular immunity triggers the reactivation of the virus, resulting in herpes zoster.
The infection presents with pain the precedes the rash. The pain may be described as a burning, throbbing or stabbing pain, the involved area may be tender to touch. The distribution of skin lesions typically occurs in an area controlled by a single spinal nerve (dermatome). Lymph nodes sometimes swell. Depending upon the area affected, there may be vision abnormalities, taste abnormalities, a drooping eyelid, hearing loss or joint pain.
Tests rarely are done to diagnose herpes zoster but may include a viral culture of the skin lesion or a microscopic examination of skin cells (Tzanck test). Herpes zoster usually is self-limiting and is treated symptomatically. No drug can eliminate the virus, but antiviral drugs may shorten the duration of the disease, especially in immunocompromised individuals. Analgesics such as aspirin or narcotics in severe cases also can be used to reduce moderate pain associated with the disease. Antidepressants are used for individuals with prolonged, severe pain and suicidal thoughts. I would advise you to consult your doctor for further management.

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