Three Doctors Three Opinions (Shingles)

[AnxietyLaden]

About 9 days ago I noticed a few red bumps on the back of my wrist.  Prior to the bumps, I do remember having localized pain in my arm and dismissed it as working out to hard at the gym, or sleeping on my arm which I have a tendency to do.  The bumps, over time, became spread out and eventually numbered 8, I thought they were bug bites or spider bites so I went to Doctor A) who was in Internist.  He said it looked like Contact Dermatitis and to go and purchase Cortaid.  Ok, so I did.  Last Friday I woke up in excruciating pain, went to Doctor B) Family Practicioner - Couldnt get an appointment with a dermatologist.  I did some research on dermatological conditions and and Shingles fit the description.  Doctor B) didn't know what it was.  He was perplexed.  When I mentioned Shingles, he mentioned ok that is what I think it is.  It kind of made sense.  I had pain in my arm before I saw the bumps before they appeared, I have been tired, not sleeping much and stressed out, and he said that he thinks the bumps were in line with my neural pathway which was a tell tale sign of Shingles.  He perscribed Valtrex and Clomitrizole Topical Ointment.  He also drew blood for an IGM test to see there is an active infection however he did not swab the blisters/bumps.  Doctor C) A dermatologist I called that had a cancellation, this was today.  He looked at it, doesn't think it's Shingles and told me to STOP taking the topical ointment but keep taking the Valtrex.  He swabbed the fluid inside one of the blisters and stated that he thought from a clinical standpoint by observation that it was folliculitis, and to put Neosporin or Bacitracin on it and await the swab test results.  I am 33 by the way.  Who do I believe, the Dermatologist, the Family Practice Doc, or the Internist.  I guess the test results will speak for themselves.  I am so frustrated. I read that Folliculitis is way more contagious then Shingles.  I feel dirty.

[maatson]

All's Well That Ends Well.

[AnxietyLaden]

The clinical diagnosis by a Dermatologist was that it was NOT Herpes Zoster.  He did this visually.  He also swabbed the fluid inside two of the lesions and that came back negative for the Varicella Virus as well as any other viruses/bacteria.  The IGM was negative as well.  I read your stats on it but I trust the word of a skin doctor over the word of a Family Practice Physician who has limited experience with shingles. One of the reasons the Dermatologist visually diagnosed it as NOT shingles was the placement of the lesions in relation to the neural pathway.  They are getting better.  And the Valtrex regimen I took, didn't do anything for me, at all.

[maatson]

Hello, The negative result for IgM does not rule out Herpes zoster as only 50 to 80% show positivity. History of pain before onset,the unilaterality, and more important the clinical diagnosis would all favour Herpes Zoster. But then when the other doctor saw you secondary folliculitis could have set in. Since you have been covered by valtrex,you need not worry.Do complete your course of medication.

[AnxietyLaden]

Thank you for your response. The IGM test came back negative for an active Herpes Zoster virus. The dermatologist stated the swab test was negative for any active bacteria/virus and does not know what the lesions are and to give it another week to see if they will heal.  I think I need to see another doctor at this point.  Nothing has really changed with the lesions even with the Neosporin. Very frustrated.

[Bhupinder Kaur, MD]

Hello,
These painful sore lesions can be due to shingles (caused by herpes zoster), herpes sores ( caused by herpes simplex virus) or folliculitis. You have to wait for the test results to confirm the diagnosis. The fluid from the blisters or sores can also be sent for examination.

I hope it helps. Take care and regards.

[AnxietyLaden]

Anyone?