What is the most likely diagnosis?
A. Contact Dermatitis
B. Herpes Zoster Ophthalmicus
C. Optic Neuritis
D. Eczema
Answer and Explanation:
Answer: B. Herpes Zoster Ophthalmicus
Explanation:
The image shows vesicular, crusted lesions over the forehead and eyelid in a dermatomal distribution involving the ophthalmic division of the trigeminal nerve (V1).This is classic for Herpes zoster ophthalmicus.
Herpes zoster ophthalmicus → Reactivation of VZV in ophthalmic branch of trigeminal nerve → painful, grouped vesicles and crusting around the eye/forehead. Risk of vision-threatening keratitis if not treated urgently.
Other options:
A. Contact dermatitis → itchy, diffuse erythema/vesicles after allergen exposure, not strictly dermatomal and not painful like this.
C. Optic neuritis → Painful vision loss, afferent pupillary defect, no skin lesions.
D. Eczema → Chronic, itchy, eczematous patches, not acute painful vesicular eruption.