Brief Answer:
May be the beginnings of shingles

Detailed Answer:
Good afternoon sir. My name is Dr. Saghafi and I am a neurologist.

Your complaint is a common one I hear from patients who are both in your age group and describe similar symptoms. I certainly hope, this is not the case but when people start having prickly feelings, pain of a sharp nature, burning sensations, very sensitive skin, and there doesn't appear to be anything present on the skin and the complaints seem to be either on the right or left sides then, in a fair percentage of those cases a rash will begin to develop within a few days to about a week which will then, spread over an entire area of the body which is generally one sided. Blister like skin breaks will develop with some producing a clear watery fluid and then, scabbing over.

The condition is referred to as Shingles and technically it is called Varicella Zoster. This turns out to be a chicken pox infection which has become dormant all these years since you may have suffered that childhood illness and now is rearing its ugly head decades later. This is common is the age group over 60-65 ocurring in about 33-50% of the population with no previous history of similar skin outbreaks.

Your best bet to get ahead of this thing (if that's what it is) is to make an appointment quickly with a neurologist, infectious disease specialist, or dermatologist in order to have them evaluate you for this entity as well as other possible problems and get you either on some type of tapering steroids such as a Medrol dose pack and then, if appropriate an antiviral agent such as Zovirax or Valtrex. More recent data might propose that such measures, even when instituted early in the course of disease, have little bearing on the outcome but I've found that in cases where Shingles does erupt, if the patient has been started BEFORE the rash breaks out that we can often reduce the duration of the rash and pain symptoms rather than allowing the rash to bloom and then, trying to "put it out."

Unfortunately, that is exactly what most patients do because they do not recognize the symptoms since there are no visible changes in the skin. But it is there and in over 98% of cases it will come out. In a small percentage of cases no rash ever develops.

Therefore, my recommendations are the following:

1. Seek out an appointment ASAP with either a neurologist, infectious disease specialist, or dermatologist and explain your symptoms. Be prepared for some bloodwork to rule out other problems as well. This is appropriate.

2. Be prepared for a rash to break out on the skin which COULD BECOME rather painful and aesthetically rather unappealing. Some doctors will agree to cover the rash over and others do not. Personally, I leave the lesions open because there are usually quite a few and they do not easily cover. Anyways, there's no reason to believe they will get infected or otherwise damaged so long as you don't poke, pick, or scratch at them! But many people certainly do complain of itching and burning pain so it'll take a little fortitude not to manipulate them in some way.

3. Be prepared to obtain a prescription for a salve which may be compounded (and most insurance companies do not cover that preparation) by a pharmacy containing an anesthetic, a pain medication, and a steroid. Although prescription for pills could be given to you I've found that patients much prefer the salve and the money is well worth the trouble. You may also receive an antiviral medication to take as well.

4. Hydrate very well, especially due to the antiviral medications which could cause kidney stones if you do not drink plenty of water while you are on it (which could be from 4-8 weeks).

5. Good luck and steer steady! I wish you best and hope this turns out to be something more simple like a sunburn.....if you'd like to provide a picture we can see but I kind of doubt it as sunburn just because you're stating that it is on your RIGHT SIDE. Sunburns will typically cover entire body parts that are exposed which would suggest both sides should've been affected....but we will see.

If you feel I have provided you with timely and useful information for the problem you have described I would appreciate your feedback by written comments and a STAR RATING. I'd also appreciate your CLOSING THE QUERY.

This case required 43 minutes of physician specific time in reviewing, researching, and compiling the final draft for envoy.

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