Photophobia and a painful rash.

A 62 year old woman presented to eye casualty with a 10 day history of a left sided headache. Two days after her headache started she developed a painful and pruritic left sided rash. During the 24 hours before presentation, her left eye had become injected, painful, and photophobic. On examination she had a well demarcated, unilateral area of erythematous andmildly oedematous skin, which extended from her left upper lid up across her forehead. Within this area were discrete tender scabbed lesions, which extended back into her hairline (fig 1). She had no lesions on the tip of her nose or in her auditory canal. No lesions crossed the midline to the right side of her forehead or scalp.