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Shingles antiviral timing — GPhC CRA MCQ

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HardInfectionsShingles antiviral timingGPhC CRA

A 69-year-old man on prednisolone 20mg daily for polymyalgia develops a painful vesicular rash in a dermatomal pattern across his chest. It started 36 hours ago and he asks for calamine lotion. What is the most appropriate action?

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Correct answer: E — Refer promptly for antiviral assessment because he is older and immunosuppressed

Shingles within 72 hours may benefit from antiviral treatment, and older age and immunosuppression strengthen the need for prompt assessment. Prednisolone increases risk of more severe infection. Calamine may soothe but does not replace antiviral consideration. Safety-netting should include eye involvement, disseminated rash and severe systemic symptoms.

Reference: NICE CKS Shingles; BNF