PMC8325583_01
Progression of the initial lesion from left to right. April 16 marks the first day of lesion appearance, April 21 marks her emergency room visit, And April 22 and 23 mark just prior to hospital admission and the following day. (a) April 16, 2020. (b) April 21, 2020. (c) April 22, 2020. (d) April 23, 2020.
CRIN2021-6663689.001.jpg
PMC8325583_01_CRIN2021-6663689.001.jpg
fig1
The morning of April 16, a grouped vesicular rash positioned along the left 3rd lumbar vertebral dermatome erupted, as shown in Figure 1. The emergency room physician took the photo shown in Figure 1 labeled April 21 and documented that the patient had similar eruptions in the upper chest and was immune compromised.
Montage of images portraying the extent of zoster dissemination and progression on April 22, despite having started oral valacyclovir the night prior during her emergency-room visit.
CRIN2021-6663689.002.jpg
PMC8325583_01_CRIN2021-6663689.002.jpg
fig2
Figure 2. Fearful of what may happen if she were to wait for a telehealth appointment with her primary-care provider, she again reached out to her nephrologists relaying her emergency-room course, the plan implemented as well as providing the photos shown in Figure 2.