A 54-year-old woman presents with prominent scattered erythematous papules on the right side of her forehead. She had “burning” pain and hypersensitivity in that area for the past 2 days. Her pain is localized to the right supraorbital area and the right aspect of the dorsum of her nose. She denies headaches, mental status changes, or recent infections. What is the most plausible diagnosis?
Correct Answer: Varicella zoster
Description: Woman is suffering from herpes zoster, or "shingles" - a late complication of prior infection with varicella zoster virus. The virus remains latent in the ganglia of sensory nerves after the primary infection. The characteristic shingles rash is always confined to a dermatome and does not cross the midline. Specifically, the area described by the patient is the right V1 dermatome.
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