Brief Answer: Kindly provide details and pictures Detailed Answer: Hello, Welcome and thanks for posting your query to the forum. I can understand your concern for the rash on the right side of your body. I have gone through the complete history provided by yourself and after thoroughly analyzing the query it appears to be rash related to shingles only. To confirm the same and guide you regarding the condition I request you to kindly tell me certain important points: - Can you please elaborate the site of occurrence of shingles. - Can you please elaborate how you noticed the condition of shingles- was there any redness or blisters over the area. -After how much of time of the shingles you developed the rash on right side. It would be best to send few good resolution pictures of the rash area so that it can be analyzed best. You have a feature to upload images by yourself at the right side of the query page, please utilize that so that I can answer your queries better. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia. Hope to hear soon form your side. Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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Brief Answer: Rash of shingles; Take Pregabalin/Amitriptyline Detailed Answer: Hello, After thoroughly analyzing the complete condition I can make out that you suffered from the Herpes Zoster (shingles) and the rash (which is subsiding now) is typically related to shingles only. To tell you briefly and simply about Herpes zoster (Shingles) – it is a viral infection caused by same group of viruses which causes chicken pox. It occurs as rash and blisters on one side of body only which can occurs either on head region or on chest region or on flank region. We consider the occurrence as worst in case if occurs on head region and of less severity if occurs on flank region (as in your case). There is inflammation of the nerves (in the skin only) by the viruses in the particular side of the body which actually causes the rash as well as the pain part and the blistering. As per age it may be limited to a small part or may be widely distributed but only one side of body strictly. So you do not worry about the various types of informations on internet. When zoster occurs before 40 years of life then it is bit mild of all and never causes much of the rash or painful symptoms as well other of the problems. As the age increases beyond 40 years it equivocally increases in severity. I have seen people having severe pain as well as rash if shingles occurs post 60 years of age. The complete illness of shingles is related to the status of immunity. As I already said it is mild in pre 40s and severe after 60s because of the fact that as the age progresses there is reduction in the immunity to combat this viral illness. Due to less immunity there is more proliferation of rash as occurred in your case too. You should not be confused with less immunity as a generalized term but in term so of the particular virus itself as well as age related factors. It occurs only on skin and never affects internal organs like kidneys or intestines or liver or any other organ. I have many times seen that because of the severity of pain people may get confused to the cause in internal organs, which is actually not. So I reassure you also that in your case also it is not related to any of the internal organs like kidneys. Moving around will not make the illness worsened. The only problem lies in the oversensitivity of the skin due to inflammation of nerves. SO you may perceive higher pain after touching of the clothes or due to movements but actually speaking is not related to worsening of the rash or the condition. You need not to stay in bed accordingly. If I were your dermatologist then rather than pain killers I would have prescribed you the medicines which can reduce the oversensitivity of the nerves. In your kind of cases I generally prescribe Pregabalin in day time (150 mg) and low-dose (10 mg) amitriptyline hydrochloride at night time after meals. This is one of the tablet which will help us out in reducing the kind of excessive sensitivity of the nerves at the affected region. The only side effect of the tablet is sedation and that is why it is to be given at night time only. I would have prescribed this tablet for one month period and observed the symptoms and the condition after one month. Even if the severity of pain is not reducing initially then would have added a pain killer such as paracetamol with tramadol on as and when required basis. An additional tablet containing Cyanocobalamin which is the most common and widely produced of the chemical compounds that have vitamin activity as vitamin B12. It can be taken twice daily to help in early healing of nerves. It may take several months to be completely alright so have patience and do not worry about the situation. My best wishes for early recovery from the problem. Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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