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Painful, itching blisters in abdomen, SHINGLES. Is VALACYCLOVIR ok?

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I'm a 56 yr old female, overall good health except for the last few months of stress caring for my mother. My usual meds include fluoxetine 40mg and lo-loestrin. Starting on 2/16, I presented with a deep pain in the lower right abdomen that changed in intensity over the next two days. I considered appendicitis but the pain was inconsistent at first, I had no nausea, and it was not painful to touch or pressure. On 2/18, I awoke to find a few red blisters in that area and by that evening the blisters had tracked around my waist to my back. Aha! Shingles - which was confirmed the next morning. I received the usual valcyclovir 1000mg tid for 7 days. I did take the prescribed hydrcodone/apap 5/325 for the pain for 3 days but have been able to use Tylenol, ibuprofen, Benadryl and topical hydrocortisone cream since then to get through the day. I'm aware of postherpetic pain after the blisters have healed but I'm not having that kind of pain. Although the blisters had started to to become less purplish-red over the first week of therapy, they have still not crusted over completely, are still red, have not decreased in the area covered and still become quite sore by the end of the day. And, of course the itching never stops. I'm just wondering if I should be seeing more improvement since it has been 18 days. At what point should I return to the physician if healing doesn't occur?

Category: Infectious Disease Specialist

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Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
Will you be able to upload an image of your blisters?
Based on that the specialist can reply.
Awaiting your reply,
Regards.


Patient replied :

I'm hoping you can open the files as I've sent them. If not, the only other way that I am experienced with sending pictures is through email and text messaging.


Hello

Thanks for posting your query. I can understand your concern.

I reviewed the pictures, i cant see the lesions very clearly but i can see a lot of flaking of the skin which indicates that the healing has begun. The itching is due to flaking. You can apply a moisturizing Lotion to soothe the itching.

However I can't see if there are any blisters still there. Scarring is common after an attack of shingles.
Usually all the blisters resolve in about 10 days. If in 18 days there are still open or sore lesions, I would recommend meeting your dermatologist as soon as possible. Meanwhile you can apply am antibiotic cream like mupirocin or fucidin twice daily in order to aid the healing process.

Please let me know if you have any queries.
Take care


Patient replied :

I'm embarrassed to say that I forgot to tell you that the flaking was due to application of Nu-Skin spray that I used earlier in the day to provide a barrier between the blisters and my clothing. It provided very minimal relief. I had bathed since then but apparently didn't get the topical completely off since I couldn't stand to use even a washcloth on that area. It finally flaked off this morning and after washing, one can see that approximately 1/4 have scabbed over. The remaining areas are itchy and sore blisters but not oozing or open. But since it has been more than 10 days, I will consult a dermatologist. Thank you


Hello

Thanks for your reply.

It's ok. Don't worry about it. But yes you would need to see a dermatologist. Meanwhile you can take an anti histamine like claritin to control the itching.

Take care


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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