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Herpes Zoster — RACP Adult Medicine MCQ

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EasyDermatologyHerpes ZosterRACP Adult Medicine

A 72-year-old man presents with a painful blistering eruption in a unilateral dermatomal distribution on the left trunk (T4-T6). Vesicles are present on an erythematous base. He is immunocompetent. Symptoms began 48 hours ago. What is the most appropriate antiviral treatment?

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Correct answer: E — Valaciclovir 1 g TDS for 7 days

Herpes zoster (shingles) in patients >50 years should be treated with antiviral therapy within 72 hours of rash onset to reduce duration, severity, and risk of postherpetic neuralgia. Valaciclovir 1 g TDS for 7 days (or famciclovir 500 mg TDS for 7 days) is preferred over aciclovir due to better bioavailability and simpler dosing. Analgesia including consideration of neuropathic pain agents should be provided.

Reference: eTG – 2025 – Antibiotic Guidelines; eTG – 2025 – Dermatology