Shingles rash or lupus rash

Patient : I went to urgent care clinic yesterday & was told this is shingles. A small bumpy rash started 5 days ago, and then 2 days ago it became red, lesion like, itchy and moderately painful. It is above, behind and below my ear on BOTH sides. A few bumps are along my jawline and nest my eye. The doctor said shingles does not present on both sides, but I have a terminal illness, Lewy body dementia, so I may be immunocompromises & therefore the shingles can be on both sides? I think it may be lupus. What do you think? I am achy, headache.
Symptoms:  See above please. Shingles rash or lupus rash?
Shingles rash or lupus rash-1 Shingles rash or lupus rash-2 Shingles rash or lupus rash-3
Doctor :   Hello, Thanks for the query to ATD, As evident from the photos, these are typical herpes zoster or shingles lesion s with raised bumps with clustered growth accompanied with the redness, itching and pain and most importantly unilateral. The spread in shingles is always unilateral and that has been characteristic. It is agreed that, due to decreased body immunity, these are the most likely viruses which tend to flare but bilateral infliction are not shingles but simplex virus infection. you may continue your Excelon and acyclovir tabs as advised and also should apply local acyclovir ointment thrice a day for 7 days over the lesions. Try to keep them dry otherwise and moisture free and avoid scratching them. The scabs are infectious and hence proper disposal for the same should be considered as they may spread to other inmates as well. I hope i have answered your query in detail, Wishing you speedy recovery, Regards

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