I wondered when someone was going to ask this one...
They do (steroids can make it run rampant) !!
Well, at least in my humble experience of one case.
This was a chap with severe early trigeminal neuralgia x 3 days and other
coexisting inflammatory disease, and I took a punt with IM steroid.
He came out in shingles over the same distribution 24-36 hours later.
That is not to say that it may not have come out anyway.
(And I've had others where the neuralgia disappeared in under 6 hours...)
If I was really concerned I would give both steroids and acyclovir. After
all steroids are cheap, and acyclovir is only a one off.
I'm not too fussed about the EBM/proof etc.
General pracdtrice is al;ways a few steps ahead of EBM anyway.
(I wouldn't say that on the EBH list of course...)
Jon Wilcox
Auckland
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> Subject: Re: Bell's palsy
> Date: Monday, January 26, 1998 1:09 PM
> Can anyone explain to me why steroids don't seem to make a herpes
infection
> run rampant as they logically should?
> Jeremy Sager
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