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Suffering From A Skin Infection. Not Getting Relief By Carbomazopine. Suggest Best Medication

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Posted on Sun, 18 Nov 2012
Question: my father is suffering from a skin infection in whch he has rashes between palm and elbow of his right arm. earlier he has on shoulders but they have faded away. n he has severe pain in his entire hand right offcourse. doctors suspect herpes zoster but 20 days he is not getting relief even from taking medicines like carbomazopine. pls help. how much tme it will take n what are the best medicines and ointment?
doctor
Answered by Dr. Das Arindam (10 hours later)
Hello ,
Firstly, herpes zoster or shingles are the reactivation of herpes Varicella Zoster Virus. Here, the primary infection presents in the form of chicken pox earlier. The most important symptom of this herpes zoster is extreme pain in one or more areas according to the distribution of a sensory nerve. Associated lymphadenopathy may also be present. Erythematous papules present in that particular dermatome.

So, from the above discussion and your father's history, the lesions are seemed to be of Herpes zoster. As you mentioned that some rashes are present between palm and elbow, it indicates an acute condition.

Investigations required for confirmation serology for IgM / IgG, culture of the scraping for isolation of virus.

Now, management of this disease
1. Rest.
2. like aceclofenac / Diclofenac group of drugs ) for pain. One pantoprazole group of drug should be taken before taking the pain killer.
3. Calamine lotion for the skin lesions.
4. Aciclovir group of antivirals should be taken.
5. Oral antibiotics ( like azithromycin group of drugs) should be taken to prevent secondary skin infection.
6. Steroids are indicated in condition where abovementioned drugs can not give any relief.
7. If there is post herpetic neuralgia then you have to take tricyclic antidepressants (like Amitriptyline group of drugs), anticonvulsants ( like carbamazepine group of drugs). Locally capsaicin cream or any local anaesthetic agent can be used.

I think the your father's condition is to be taken as acute presentation and should be treated more meticulously. The carbamazepine group of drugs which are used in post herpetic neuralgia has little role in acute painful condition.
So, consult with your treating doctor about the abovementioned drugs for their dose distribution and frequency.
Lastly, for your information , these viral conditions will take about 4 -5 weeks to be cured completely.

Hope this information suffices. Let me know, if you have any more question.

regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Das Arindam (2 hours later)
thanks a lot.
i think it will give my father much-needed relief.
doctor
Answered by Dr. Das Arindam (1 hour later)
Hello,
Thank you for writing back.
If you have answer of your queries, you can close this discussion.
Rating and review given by you will be appreciated.

Take care.
Regards.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Das Arindam

General & Family Physician

Practicing since :2008

Answered : 1416 Questions

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Suffering From A Skin Infection. Not Getting Relief By Carbomazopine. Suggest Best Medication

Hello ,
Firstly, herpes zoster or shingles are the reactivation of herpes Varicella Zoster Virus. Here, the primary infection presents in the form of chicken pox earlier. The most important symptom of this herpes zoster is extreme pain in one or more areas according to the distribution of a sensory nerve. Associated lymphadenopathy may also be present. Erythematous papules present in that particular dermatome.

So, from the above discussion and your father's history, the lesions are seemed to be of Herpes zoster. As you mentioned that some rashes are present between palm and elbow, it indicates an acute condition.

Investigations required for confirmation serology for IgM / IgG, culture of the scraping for isolation of virus.

Now, management of this disease
1. Rest.
2. like aceclofenac / Diclofenac group of drugs ) for pain. One pantoprazole group of drug should be taken before taking the pain killer.
3. Calamine lotion for the skin lesions.
4. Aciclovir group of antivirals should be taken.
5. Oral antibiotics ( like azithromycin group of drugs) should be taken to prevent secondary skin infection.
6. Steroids are indicated in condition where abovementioned drugs can not give any relief.
7. If there is post herpetic neuralgia then you have to take tricyclic antidepressants (like Amitriptyline group of drugs), anticonvulsants ( like carbamazepine group of drugs). Locally capsaicin cream or any local anaesthetic agent can be used.

I think the your father's condition is to be taken as acute presentation and should be treated more meticulously. The carbamazepine group of drugs which are used in post herpetic neuralgia has little role in acute painful condition.
So, consult with your treating doctor about the abovementioned drugs for their dose distribution and frequency.
Lastly, for your information , these viral conditions will take about 4 -5 weeks to be cured completely.

Hope this information suffices. Let me know, if you have any more question.

regards.