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Herpes Zoster — SCE Dermatology MCQ

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EasyCutaneous InfectionHerpes ZosterSCE Dermatology

A 22-year-old university student presents with a painful vesicular eruption in a dermatomal distribution on the left T5 dermatome. He is otherwise well and immunocompetent. What is the most appropriate first-line treatment?

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Correct answer: E — Oral Aciclovir 800 mg five times daily for 7 days

For immunocompetent patients with herpes zoster, oral Aciclovir 800 mg five times daily for 7 days is the recommended treatment, ideally started within 72 hours of rash onset. Valaciclovir 1000 mg three times daily (not 500 mg twice daily) is an alternative with better bioavailability. Intravenous Aciclovir is reserved for immunocompromised patients or disseminated disease. Topical antivirals alone are insufficient. Young, immunocompetent patients with uncomplicated shingles do not require IV therapy.

Reference: BAD/BHIVA 2022 Guidelines for management of VZV