Shingles Strikes With a Vengeance

3. For several months, a 69-year-old woman has had a rash around her eyes. It is terribly symptomatic, burning and itching regardless of any type of OTC treatment. She finally requests referral to dermatology from her primary care provider.

Diagnosis: Eyelid dermatitis, or irritant contact dermatitis, is an extremely common complaint, and this patient’s history is quite typical: The worse the problem gets, the more attempts the patient makes to relieve symptoms.

When this patient presented to dermatology, she was applying six different products (all OTC) to the affected areas. None helped, and in fact, most seemed to worsen the problem. Even if one had helped, she would never have known which. But desperation drives patients to do irrational things, especially when the problem is out in the open for the whole world to see.

For more information, see “The Eyes Have It, and It Itches Like Crazy.” Clinician Reviews. 2015;25(9):W1.