Case history: A 52-year-old male presented with a 3-day history of vesicular erythematous rash on the back of his right shoulder. He complained of minimal occasional ilch associated with the rash, but no pain before or after the appearance of the vesicles. He remembered having chicken pox in his childhood. Examination revealed the characteristic vesicular rash of shingles along the mid-part of the right scapular region (C7/C8 dermatome) (Figure 1). After discussing with my trainer, this seemed to be an example of an atypically painless Herpes zoster. Oral aciclovir was commenced and the lesions started to fade in 2 weeks. No pain was reported during or after treatment.
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