Dermatology Infections: Viral--Clinical Symptoms and Signs

Herpes zoster

John L. Bezzant,M.D.

This patient developed herpes zoster in the first branch of the trigeminal nerve. Note that she has crusting present which could be secondary to resolving herpetic lesions or to secondary infection, usually with staphylococcus aureus. I performed Gram stain of the under-surface of the crust, and she had numerous Gram-positive cocci confirming secondary infection with probable staphylococcal aureus. If the globe of the eyes is involved with erythema, or if the tip of the nose is involved (involvement of the nasociliary branch), or if the patient complains of any facial disturbance, make sure you have an ophthalmologist examine the patient.