50 y/o/m presented with such type of skin lesion( reddish & raised from surface ) on unilateral cheek & nose associated with pain & burning sensation.He has also carries in upper teeth of the same side.O/E TPR NORMAL.Tonsilar / posterior auricular / submandibular lymp nodes ENLARGED.What should be the Dx & Mx in this case.Please give your opinion.Thank You.

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D/dx - Chronic Infected seborrheic dermatitis Post herpetic neuralgia Malignant melanoma Trial of penicillin antibiotics with anaerobic coverage If no response advise fnac of lymph node and lesional biopsy for hp.

Post-herpetic lesions with scans. Treat symptomatic treatment

h erpetic dermatitis

Herpes zoster trigeminalis

How much day

3 days sir
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H. Zoster??

There is no vesicular eruption sir
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Post-herpetic neuralgia. The scabs will eventually fall of but depigmented patches may remain for some time. For the neuropathic pain Tab Amitriptyline 10 mg hs and gradually increase to 50 mg hs; alternately Cap Pregabalin 75 mg bd till pain is achieved. Meanwhile, also add NSAID of your choice (along with a PPI to prevent gastritis). Oral Tramadol may be give prn. Capsacin topically is another alternative, but caution should be observed as the lesions are near the eye. Is there any opthalmic involvement? Rule out DM.

How about keeping in mind lepra reaction as a one dd ???
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Rule out herpes

DD Urticaria, lepra reaction . traumatic

Cellulitis.

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