The middle aged lady pulled up the hem of her wrap to reveal her thigh. She said that a few days ago, she had felt some mild tingling and irritation in the area. Yesterday, a crop of tiny painful blisters appeared.
She applied the juice from a bush fruit, “haw way tuh” in Karen, and this has stained the skin brown.
This is shingles (herpes zoster), of course. It is affecting the fourth lumbar dermatome.
The locals call it “yu-eh” or mouse droppings. I suppose it does look similar, especially with the brown staining.
She was not able to sleep last night because of the irritation and discomfort, so I prescribed 10mg amitriptyline to be taken at night. It should help her sleep, reduce the neuropathic pain and lessen the chance of her developing post herpetic neuralgia.