ABSTRACT: Herpes zoster or shingles is a dermatological disorder which is caused by the reactivation of the varicella zoster virus, lying dormant in the neurological system of the human body. Someone who ever had a chicken pox in their life is at high risk of getting herpes, as it’s the same dormant virus.
However, you cannot infect someone else with shingles; you could infect them with chickenpox if you are suffering from shingles. This is a case report of a 16- year-old boy presenting with blister like rashes on the right side of his back accompanied by fever with burning, pain and itching. After proper case taking and repertorization homoeopathic medicine was given which resulted in an improvement.
KEYWORDS: Herpes zoster, Homoeopathy, Shingles, Unilateral lesion, Blisters.
INTRODUCTION: Herpes zoster is a viral skin infection that looks like blisters and are painful. It is also known as Shingles. It is actually the reactivation of the virus, varicella-zoster. In the neurological system, the varicella-zoster virus remains slumbering following an episode of chicken pox. But most often, herpes zoster affects adults or the elderly.1
Nevertheless, the latent VZV revives when the body’s defenses are weakened, causing symptoms of herpes zoster, such as scorching pain, itching, and an increased ribbon of red rashes across the sensory nerve ganglia, accompanied by the formation of clear blisters that could be connected to a fever.2
Humans are susceptible to the eight herpes viruses, including the varicella zoster virus. Being in close proximity with the lesion or airborne transmission are the most common ways for it to spread. The varicella virus causes a widespread rash during the original infection by spreading through the bloodstream to the skin, oral mucosa, and lymph nodes. There are established risk factors for viral reactivation, including age, stress, immunocompromised condition, and immunosuppressive medications.3
This blisters or eruptions usually lie only in one side of the body i.e. unilaterally, which is characteristic for shingles. The rash on the left or right side of the body is the most typical symptom of herpes. Usually, the rash hurts, itches, or tingles. There can be major consequences from shingles, if left untreated for a long duration. The most frequent side effect of shingles is post-herpetic neuralgia, which is persistent nerve pain.4
The bad effects of herpes zoster can be seen in rural areas very often, as the transmission of the disease is with direct physical contact. Due to less awareness regarding disease and bad hygiene, rural region is more at risk. As the disease progresses its severity also increases. The incidence of chicken pox in India is high and so that shingles. Someone who had chicken pox in their life is at high risk of getting herpes zoster, as it is the reactivation of chicken pox virus which used to lie slumbered in our neurological system.
For prevention, one should take the vaccine. It is advised to protect yourself and others by following the precautionary steps of disease prevention. Although you cannot infect someone else with shingles, you could infect them with chickenpox if you are suffering from shingles. To prevent spreading the chickenpox virus, keep the rash covered and stay away from people until it has entirely gone away.5
CASE PRESENTATION: A male patient, 16-years old came to the clinic on 05 June, 2024 with chief complaints of blister like rashes in a bunch on the right side of his back since two days. He had fever the last two days. It was very painful with burning, redness and itching. Burning was severe and aggravated by touch.
Itching and burning was aggravated by sun exposure as well. It had a crawling sensation in the affected area. There was no discharge from the eruptions and no other associated symptoms.
HISTORY OF PRESENTING COMPLAINTS: This had started suddenly in just 1-2 days with dawn of fever and fatigue. Patient has started noticing mild redness in the affected area and then suddenly after fever he had these blisters.
Afterwards, itching in the affected area has started which was followed by the intense burning and pain. He had all the blisters only in the right side of upper back which gradually increasing in size.
PAST HISTORY: The patient has history of pneumonia at age 3 and chicken-pox at 8 years.
FAMILY HISTORY: His parents died in an accident around 2 years ago. His brother and sister do not have any abnormality.
PERSONAL HISTORY: Patient is non-vegetarian. He has received all of his vaccines on schedule and experienced no known negative side effects. His developmental milestones are on time. No specific allergy present. He likes playing games with friends.
PHYSICAL GENERAL:
Desire: Likes spicy and salty foods.
Aversion: Nothing Specific.
Appetite: Adequate; 3-4 chapattis/meal.
Thirst: 1-2 liter/day. Takes seasonal water.
Stool: Satisfactory but sometimes disturbed bowel habit.
Urine: D3-4 N0. Normal, clear, without any other issue.
Sweat: on armpits, on soles and palms, on head; non offensive, non-staining.
Thermal Reaction: Hot; even in winters going out in sun is unbearable.
Sleep: Sound refreshing sleep of 7-8 hours.
LIFE SPACE: Patient lost his parents at a very young age. He has one older brother and one older sister. He was the youngest child in his family. Since one year he is working in a grocery store to help his family and left his school.
MENTAL GENERALS: Patient was so quiet and reserved in nature; he used to be on his own. He used to work even at this young age so that he can help his brother. He felt a sense of responsibility. He became irritable on small matters. He used to miss his parents but never shows his sadness to anyone, cries when alone.
GENERAL EXAMINATION: Patient was ectomorph with 149 cm height and 47 kg weight. His pulse was 76 beats per minute with 110/70 mmHg blood pressure. His respiratory rate was 16 breaths per minute. His nutrition was good and there were no sign of pallor, icterus, cyanosis and lymphadenopathy.
LOCAL EXAMINATION: There are maculo-papular grouped rashes present on the right side of upper back and these were unilateral in appearance. They are red in appearance with itching and tingling sensation.
PROBABLE DIAGNOSIS: It was diagnosed as Herpes Zoster clinically.
Fig.2 (zoomed view of rashes.)
Fig.1 (before Treatment
on 05/06/2024)
DIFFERENTIAL DIAGNOSIS:
- Herpes Simplex Virus (HSV): Blistering rashes are a symptom of both shingles and herpes simplex. Usually, herpes simplex affects the lips, face, genitalia, or rectum. On the other hand, one side of the body near the waist is typically affected by shingles. Every kind of rash has a unique appearance. Other symptoms can also be used to distinguish between them.6
- Impetigo: Impetigo is a disease caused by bacteria that affects the outermost layer of the skin, called the epidermis. Collectively this illness is caused by a bacterium called Streptococcus pyogenes. Although it mainly affects children, adults may also be impacted. Red skin sores on your arms, legs, or face are typical signs of impetigo. Blisters form from these lumps, burst, scab over, and turn a crusty yellow-brown. If you scratch the rash, it may spread to other places of your body, even though it usually starts in one place.7
- Chicken-pox: The Varicella-zoster virus (VZV), a single member of the herpes family, is the cause of both chickenpox and shingles. Upon initial exposure to VZV, a person develops varicella, also known as chickenpox. Shingles, also known as herpes zoster, are caused by the virus reactivating later in life, typically decades after chickenpox.8
- Allergic Contact Dermatitis: Shingles is a viral infection while allergic contact dermatitis is a result of some allergic reaction of one’s body. Shingles only appear on one side of the body and are localized. Dermatitis typically affects a big portion of the body and can develop on both sides; the rash in dermatitis can frequently feel itchy but not associated by any nerve pain or tingling. On the other hand, the painful rash in shingles usually develops after a few days of intense pain, burning, or tingling on the skin.9
ANALYSIS & EVALUATION OF SYMPTOMS:
| MENTAL GENERALS | PHYSICAL GENERALS | PARTICULARS |
| • Quiet & reserved in nature.
• Likes to be in his own. • Feeling of responsibility. • Irritable on small matters. • Cries when alone. |
• Desire for spicy & salty things.
• Sweat on armpits, on soles and palms. • Sun exposure intolerable. • Thermal is hot.
|
• Blister like rashes with burning pain and itching.
• Crawling sensation in affected area. • Itching and burning aggravated in sun exposure. |
TOTALITY OF SYMPTOMS:
- Quiet & reserved in nature.
- Feeling of responsibility.
- Irritable on small matters.
- Cries when alone.
- Sun exposure intolerable.
- Blister like rashes with burning pain and itching.
- Crawling sensation in affected area.
- Itching and burning aggravated in sun exposure.
REPERTORIAL TOTALITY: Repertorization was done with the help of synthesis repertory by using RADAR 10.0 Version. Synthesis Repertory has been chosen due to the presence of marked mental generals and particulars. The following rubrics are analyzed for final repertorization:
- MIND – RESPONSIBILITY – taking responsibility too seriously
- MIND – WEEPING – alone, when
- MIND – IRRITABILITY – trifles, from
- SKIN – ERUPTIONS – blisters
- GENERALS – SUN – exposure to the sun
PRESCRIPTION: On 05th June, 2024, Natrum muriaticum 30C two dose for a day followed by Saccharum lactis, 4 globules thrice a day for 15 days.
JUSTIFICATION OF PRESCRIPTION: Natrum muriaticum was selected on the basis of totality of symptoms and differentiation between other remedies was done by following materia medica. The thermal of the patient was hot and marked aggravation from sun exposure was present. He has irritable temperament and reserved nature. Burning and pain was present in eruptions. Itching was aggravating by sun exposure and heat.
FOLLOW-UP OF THE CASE:
| S.N. | DATE | SYMPTOMS | PRESCRIPTION |
| 1. | 05-06-24
(Fig 1 & 2) |
Blister like rashes with burning pain and itching. Crawling sensation in affected area. Itching and burning aggravated in sun exposure. | Natrum muriaticum 30/two dose for a day. Saccharum lactis, 4 globules thrice a day for 15 days. |
| 2. | 22-06-24
(Fig 4) |
Blister like rashes disappear completely but itching and pain present. There was very mild burning left now. | Saccharum lactis three times a day for 15 days.
|
| 3. | 08-07-24 | No new rash appears but no change in itching was there. | Natrum muriaticum 30/two dose for a day. Saccharum lactis, 4 globules thrice a day for 15 days. |
| 4. | 16-07-24
(Fig 5) |
No new rash, no itching, no burning and pain. Patient feeling much better. | Saccharum lactis three times a day for 15 days. |
Fig. 4 (on 22/06/24) Fig. 5 (on 16/07/24)
RESULTS: The entire blister like eruption on his back was completely resolved. There was no itching, no pain and burning now. He even has no aggravation on sun exposure now. He is doing great nowadays.
DISCUSSION: Herpes zoster is an infectious disease which can be worse if left untreated. It is very common among those who have a history of chicken pox. It can be mixed up with many other diseases like Herpes simplex (HSV), contact dermatitis and bullous impetigo etc.
HSV and bullous impetigo are more likely to be localized centrally, to cross the midline, and to be more randomly dispersed than the dermatomal distribution of herpes zoster. The exposed area, which is typically different but may coincide with a dermatomal distribution, is where contact dermatitis is localized.
The herpes zoster distribution is more unilateral with painful vesicular eruptions. There are numerous cases which were treated with therapeutic and individualized homoeopathic medicines and have shown wonderful results. This case of a teenage boy has shown the marvelous result of homoeopathy with pictorial proof.
CONCLUSION: Homoeopathy can treat many dermatological issues in a very short period. This case has proved the effectiveness of Natrum muriaticum in treating herpes zoster in a very short span. The medicine was selected on the basis of totality of symptoms and with the help of materia medica. The case has shown rapid and gentle improvement within a month approximately. All the blisters were treated completely and no other problem came in knowledge. This has proved the effectiveness of homoeopathy in treating herpes zoster.
FINANCIAL SUPPORT: None.
CONFLICT OF INTEREST: None.
INFORMED CONSENT: Without revealing the patient’s identity, the patient’s consent was fully obtained for registration as per ethical standards for treatment and publication.
REFERENCES:
- Nair, P. A., & Patel, B. C. (2025a). Herpes zoster. In StatPearls. StatPearls Publishing.
- Jaijakul, S. (2023, April 11). Herpes zoster: Causes, symptoms, treatments. MedPark Hospital. https://www.medparkhospital.com/en-US/disease-and-treatment/herpes-zoster-shingles.
- Koshy E, Mengting L, Kumar H, Jianbo W. Epidemiology, treatment and prevention of herpes zoster: A comprehensive review. Indian J Dermatol Venereol Leprol 2018;84:251-262.
- (2025, January 17). About shingles (herpes zoster). Shingles (Herpes Zoster). https://www.cdc.gov/shingles/about/index.html
- (2023, August 24). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/11036-shingles
- Veazey, K. (2022, November 28). How to tell the difference between herpes and shingles. Medicalnewstoday.com; Medical News Today. https://www.medicalnewstoday.com/articles/shingles-vs-herpes
- HealthMatch Pty Ltd. (2022, November 30). Shingles vs impetigo: What you should know. HealthMatch. https://healthmatch.io/shingles/shingles-vs-impetigo
- (N.d.). Mountsinai.org. Retrieved June 5, 2025, from https://www.mountsinai.org/health-library/report/shingles-and-chickenpox-varicella-zoster-virus
- Shingles – Herpes Zoster. (2022, May 25). Dermatology and Skin Health – Dr. Mendese. https://dermskinhealth.com/conditions/shingles-herpes-zoster/
