Hal Flowers, MD Robert T. Brodell, MD University of Mississippi Medical Center, Jackson (Dr. Flowers and Dr. Brodell); University of Rochester School of Medicine and Dentistry, New York (Dr. Brodell) rbrodell@umc.edu
DEPARTMENT EDITOR Richard P. Usatine, MD University of Texas Health Science Center at San Antonio
Dr. Flowers reported no potential conflict of interest relevant to this article. Dr. Brodell serves on speakers’ bureaus for Galderma Laboratories LP, PharmaDerm, and AbbVie. He has served as a consultant for F. Hoffmann-La Roche AG and Galderma Laboratories LP, and has performed multicenter clinical trials for Janssen Pharmaceuticals, Galderma Laboratories LP, and Genentech.
Our patient thought she had a case of “recurrent shingles,” but the location of the blisters and the frequency with which they appeared told a different story.
A 35-year-old woman sought care at our dermatology clinic with the self-diagnosis of “recurrent shingles,” noting that she’d had a rash over her sacrum on and off for the past 10 years. She said that the tender blisters typically appeared in this area 3 to 4 times per year (FIGURE) and that their onset was occasionally associated with stress. The rash tended to resolve—without treatment—within 5 to 7 days. The patient had no other medical problems or symptoms. Physical examination revealed 3 groups of vesicular lesions, each on an erythematous base, located bilaterally over the gluteal cleft.
WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU TREAT THIS PATIENT?
