shingles?

[lna2rn]

I have a patient who is on precautions for shingles, this is fine but what she has does not look like shingles at all. Many of us have had this discussion at work but of course we would not question the MD. So my question to you is:

Is it possible to have shingles in an abdominal fold and only in one abdominal fold, the epidermis has eroded and is purulent. There are no tracks or reddened areas anywhere else. I would realy like to know if anyone else has seen this manifestation of shingles.

[nurse_clown]

sounds like "yeast" out of control to me. does it cause severe pain? has it spread? what about the antivirals?

what about referring to the wound care team?

[lna2rn]

I have asked all of these questions to the day charge nurse. He just says the doctor dx it as shingles and until he changes it that is the way we treat it. I asked if it could be yeast (looks yeasty) and he just spit out the same thing he had just said. I know I am an LNA and not a nurse but I feel like something more should be done. I am glad that I am not crazy in thinking it is yeast though.

[ceecel.dee, MSN, RN]

Skin can be so vague, can't it?

The job to have is that of a Dermatologist; no emergencies and only 3-4 creams to prescribe, and $ for constant remodeling! If you don't mind the lack of excitement, it'd be IT!

[SFCardiacRN]

Is the lesion unilateral? If it crosses the midline, I doubt the shingles diagnosis.

[paulacath]

have there been any scrapings done? I'm used to seeing lab results for a hospitalized shingles diagnosis......

[lna2rn]

It is in the crease of the fold and does not track up or down. It stays within the crease. Unfortunately because I am the aid I am not privy to lab reports, and we are now on computerized documentation so no more peeking at the chart. I will ask tommorro at work though and see if I can get the info.

[gary_rn]

Shingles typically follows a nerve path. If on the abdomen it usually goes from the mid abdomen and often times travels around to the mid lower back region. if it is only in an abdominal fold and if it especially did not or does not have any vesicles then I doubt it is shingles. The vesicles appear early in the disease process then dry up. Shingles is also usually very painful.