Symptoms first developed towards the end of a holiday in a tropical forest setting
Each had similar symptoms to the other
Principal symptom was pruritus (itching and scratching)
Both cases responded very well to 2 doses of oral ivermectin, 7 days apart
About 3 weeks later, one of the partners re-presented with a rash and reported to staff as scabies that hadn't settled fully
However, the principal symptom was pain, with a mild itchy feel at times
The diagnosis was Herpes zoster (shingles) affecting the Left C6 distribution
This case is due for review in a few days
KEYS TO DIAGNOSIS IN THESE CASES
- SYMPTOMS
- SCABIES IS ASSOCIATED WITH INTENSE PRURITUS
- SHINGLES IS ASSOCIATED WITH SIGNIFICANT PAIN
- DISTRIBUTION
- SCABIES HAS A CLASSIC DISTRIBUTION, INCL GROIN, BREASTS, BUTTOCKS, WRISTS & ANKLES
- HERPES ZOSTER PRESENTS IN A DERMATOME DISTRIBUTION
