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Scenario: A 35-year-old woman presents to the walk-in clinic with an erythemic rash along her left lateral rib area, somewhat under her breast, which she describes as “very painful.” You note it has a few vesicles developing. The woman has a 6-month-old infant who is breastfeeding and three other children over 3 years of age, all of whom the parents have chosen not to vaccinate against common childhood illnesses. The woman describes recent stress related to providing 24-hour care in her home to her mother, who is seriously ill. The woman is seeking treatment for the painful rash.

  1. Which conditions should be included in your list of differentials?
  2. What additional information should be gathered to make the diagnosis?
  3. Which condition is the woman likely experiencing?
  4. What treatment plan should you prescribe for the woman?  Provide full prescription details.
  5. Based on the likely diagnosis, what are your concerns about the other members of the family?
  6. What patient teaching should you include?
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