What sign in herpes zoster ophthalmicus indicates possible ocular involvement?

What sign in herpes zoster ophthalmicus indicates possible ocular involvement?

• A. Hutchinson's sign
• B. Koplik's spots
• C. Tzanck smear
• D. Nikolsky sign

Answer: (A)

Hutchinson's sign. When herpes zoster involves the nasociliary branch of the ophthalmic division, vesicles on the tip of the nose indicate that the eye-facing nerves are affected and ocular structures are at risk. This sign means there’s a high likelihood of eye involvement such as keratitis, uveitis, or conjunctivitis, so urgent ophthalmology evaluation and prompt antiviral therapy are warranted to prevent vision loss. Koplik spots are seen in measles, not zoster; a Tzanck smear is a diagnostic test for herpes but not a clinical sign of eye involvement; Nikolsky sign is associated with pemphigus and similar conditions, not ocular involvement in zoster.

Hutchinson's sign. When herpes zoster involves the nasociliary branch of the ophthalmic division, vesicles on the tip of the nose indicate that the eye-facing nerves are affected and ocular structures are at risk. This sign means there’s a high likelihood of eye involvement such as keratitis, uveitis, or conjunctivitis, so urgent ophthalmology evaluation and prompt antiviral therapy are warranted to prevent vision loss. Koplik spots are seen in measles, not zoster; a Tzanck smear is a diagnostic test for herpes but not a clinical sign of eye involvement; Nikolsky sign is associated with pemphigus and similar conditions, not ocular involvement in zoster.