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    Geriatric Patient with New-Onset, Painful, Vascular Rash on Face

    Geriatric Patient with New-Onset, Painful Vesicular Rash on Face - Clinical Patient Case of the Week

    Try this free Viral Infections Case Q&A courtesy of Med-Challenger.

    This opioid toxicity case comes from our Family Medicine Review.

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    Try this case and test your knowledge of viral infections.

    An 83-year-old man presents to you with new-onset vesicular rash around the right upper quadrant of his face that he tells you is very painful (see Figure)..
    Viral Infections - Hutchinson Sign


    On examination, you note that the rash also appears on the tip of his nose. What is the significance of this finding?

    Answer Options:

    This finding doubles the patient’s risk of developing chronic ocular inflammation with possible vision loss.

    This finding is a strong predictor of immunosuppression and disseminated vascular disease.

    This finding should prompt thorough examination of the ear.

    This finding is an independent predictor of the presence of an autoimmune disorder.

    Approximately one-third of patients with this finding will also develop oral lesions.


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