(Disclaimer: This article is for scientific use only, and the relevant information in the following content has been processed in order to protect patient privacy)
Abstract: After a 19-year-old girl went to a classmate’s house to stay overnight, small crystal clear blisters appeared scattered on the skin surface of her body, accompanied by mild localized itching of the skin and significant fluid outflow after the blisters ruptured. After coming to our hospital for examination, he was diagnosed with adult chickenpox, a more common viral rash. After choosing oral medication with topical medication and following the doctor’s instructions for a full course of treatment, the blisters gradually dried up and the condition improved.
Basic information】Female, 19 years old
Type of disease】Adult chickenpox
Hospital】Harbin Hospital of Traditional Chinese Medicine
Date of consultation】May 2022
【Treatment plan】Medication (Valacyclovir Hydrochloride Tablets+Glucomannan Lotion+Penciclovir Cream)
Treatment period】Now home treatment for 15 days, continue to use medicine to improve after the outpatient review
Effectiveness】The blisters on the skin surface gradually dried up.
I. Initial consultation
A young girl came to the hospital and reported that she had gone to a friend’s house for a night 5 days ago and found some small blisters on the skin surface 2 days later, and then similar blisters appeared on other parts of her body within 1 day. The skin around the blisters was red and mildly itchy. On examination, teardrop-shaped blisters based on erythema were seen scattered on the skin surface of the girl. They were distributed on the trunk, ankles, and face, and individual blisters appeared to rupture due to clothing friction, and clear fluid could be seen flowing out.
Based on the patient’s clinical presentation and experience, a high probability of adult chickenpox was considered. After communication with the patient, the patient agreed to undergo routine blood work for a definitive diagnosis. The routine blood results showed decreased neutrophils, and the results of the viral infection test were considered to be consistent with the diagnosis of adult varicella.
II. Treatment history
The blister-like changes on the patient’s skin surface had been present for 3 days, and the symptoms might gradually worsen over the next 5-10 days. After communicating with the patient to determine the treatment plan, the patient was given oral vacciclovir hydrochloride tablets, which have an antiviral effect and can inhibit the reproduction of varicella-zoster virus, so that the symptoms on the skin surface will subside as soon as possible. Where there are blisters on the surface of the skin without rupture, apply stove glycolic lotion directly to relieve local itching through its astringent-drying and anti-itching effect, and gradually dry up the blisters. After the blisters have dried up, penciclovir cream, which is also an antiviral drug, is applied to the local skin surface to make the local viral rash subside as soon as possible. After the patient received the medication, the patient was instructed to be patient and use the full course of treatment, and the patient nodded that he understood and went home to administer the medication.
III. Treatment effect
The patient gave a phone call on the 15th day of medication: The patient said that the small blisters on the skin surface gradually dried up after 3 days of medication, but new small blisters kept growing on other parts of the body. After about 7 days of medication, the itching symptoms on the body were obviously relieved and the new blisters on the surface of the skin basically stopped growing. After 10 days of medication, the blisters on the surface of the body had basically dried up completely. In some places, exudation-like changes appeared on the skin surface due to the rupture of blisters. By the date of the phone call, the patient had been on the medication for 15 days, and the skin damage on the surface of the patient’s skin had basically completely disappeared. The patient was instructed to continue to use the medication to consolidate the treatment but the skin surface of the body, and to return to the clinic for a review after the symptoms had completely subsided.
IV. Notes
I am glad that the patient’s body gradually recovered after treatment with medication. During the recovery process patients need to be careful not to pick the chickenpox to avoid the formation of depressed scars. As the disease is contagious, it is recommended to keep a certain distance from others to avoid infecting them. The patient should pay attention to the diet, do not drink alcohol and eat less spicy and stimulating food to avoid aggravating the symptoms of chickenpox. If the patient’s body temperature rises rapidly during the treatment period, such as reaching 40℃ or more, it is recommended to be hospitalized in time. If other erythema and papule-like changes appear on the skin surface during the medication, stop taking the medication and go to the hospital for follow-up in time to prevent drug allergy.
V. Personal insight
Chickenpox itself is a contact infectious disease caused by varicella-zoster virus infection in the human body. Typically, chickenpox symptoms may develop rapidly into typical small blisters within 24 hours after the onset of symptoms, and may cause similar lesions on the oral mucosa and genital area in addition to involving the skin surface. After the appearance of these symptoms, you can urgently go to the hospital and choose the appropriate medication to relieve the discomfort under the guidance of a medical professional.