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Emergency Medicine


Answer 3
  1. Valcyclovir. Valcyclovir is the preferred treatment for this patient with classic herpes zoster. Antiviral therapy with or without corticosteroids is the mainstay of acute management of herpes zoster. Valcyclovir and famcyclovir have a superior pharmacokinetic profile and simpler dosing regimens than acyclovir.6 Gabapentin is one of several options for postherpetic neuralgia, but it is not generally indicated in the acute setting. Lidocaine patches are used to treat postherpetic neuralgia and should only be applied to well-healed skin with no active lesions. Anticonvulsants (nortriptyline or desipramine) and capsaicin cream can also be used for the treatment of postherpetic neuralgia.

    REFERENCES
    6. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med 2002;347:3406

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