A 50-year-old patient develops dermatomal pain followed by vesicular eruption in the V1 distribution (ophthalmic herpes zoster). Hutchinson's sign (vesicles on nasal tip) is present. This sign predicts:

• A Zoster ophthalmicus with ocular complications (nasociliary branch involvement) ✓
• B Ramsay Hunt syndrome (geniculate ganglion involvement)
• C Post-herpetic neuralgia development
• D Zoster sine herpete

Explanation

Hutchinson's sign (vesicles on nasal tip/ala) indicates nasociliary nerve branch involvement of V1 (ophthalmic division of trigeminal nerve). The nasociliary nerve supplies the eye (ciliary body, iris, cornea) and the nasal tip; its involvement predicts high risk of ocular complications including keratitis, uveitis, and optic neuritis (zoster ophthalmicus). Ramsay Hunt syndrome involves the geniculate ganglion (VII+VIII) with auricular vesicles and facial palsy. Hutchinson's sign doesn't predict PHN.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.