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What causes fluid filled lesions on neck?

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Posted on Thu, 24 Jul 2014
Question: Summary:
Rash and pain in the neck.
Details: My mother in Law is 63 year old.She spotted a slight pain and rash in her right side of neck 2 days back. Now, after 2 days, the rash developed as blister and pain extended few more inches around the rash.

We consulted general physician here, she alarmed that this could be initial herpes virus reaction and prescribed anti viral drugs. She also asked her to be quarantined. We wanted another opinion so consulted another local doctor he mentioned that it does look like herpes but ruled out because of redness in the region, so he prescribed antibiotics and said the if rash/blister spreads it will be diagnosed with virus infection.Both, doctors asked us to come back in 2 days.

We are very confused and requires conclusive opinion.
1. Please see the attached picture and provide your opinion.
2. If this is herpes what signs to look for?
3. If there any clinical way to diagnose/confirm virus infection? such as blood test?

Thanks
doctor
Answered by Dr. Kakkar S. (22 minutes later)
Brief Answer:
Herpes Zoster

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query and I have understood it. I have also looked at the Image. I can see fluid filled grouped lesions.

This does look like a case of Herpes Zoster, although the rash is localized. It may or may not spread further.

Herpes Zoster or shingles classically presents with a rash composed of fluid filled lesions on a particular part of body(trunk, face or limbs) within a localized area known as a dermatome (supplied by a single spinal nerve) and it gives the appearance of arrangement in a stripe pattern. The lesions are mostly unilateral , are grouped vesicles with a central umblication and may be associated with symptoms such as pain, burning etc.

Diagnosis is clinical and treatment is with an oral antiviral e.g Acyclovir 800 mg, four times/day for a week OR Valacyclovir 1000 mg,three times/day for a week.

Topically she can use an OTC antibacterial e.g 25 mupirocin ointment, twice daily.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (31 minutes later)
Thanks for the answer.
How contagious is it? How to avoid spreading to others?
doctor
Answered by Dr. Kakkar S. (4 hours later)
Brief Answer:
Herpes

Detailed Answer:
Hi.

It is not very contagious. However, since it is caused by reactivation of the same virus which causes chicken pox, therefore those who have never had chicken pox, should stay away for a little while, till it dries up.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 9470 Questions

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What causes fluid filled lesions on neck?

Brief Answer: Herpes Zoster Detailed Answer: Hello and welcome to healthcaremagic I am Dr. Kakkar. I have gone through your query and I have understood it. I have also looked at the Image. I can see fluid filled grouped lesions. This does look like a case of Herpes Zoster, although the rash is localized. It may or may not spread further. Herpes Zoster or shingles classically presents with a rash composed of fluid filled lesions on a particular part of body(trunk, face or limbs) within a localized area known as a dermatome (supplied by a single spinal nerve) and it gives the appearance of arrangement in a stripe pattern. The lesions are mostly unilateral , are grouped vesicles with a central umblication and may be associated with symptoms such as pain, burning etc. Diagnosis is clinical and treatment is with an oral antiviral e.g Acyclovir 800 mg, four times/day for a week OR Valacyclovir 1000 mg,three times/day for a week. Topically she can use an OTC antibacterial e.g 25 mupirocin ointment, twice daily. Regards