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This patient was referred for a persistent buttock lesion that developed during a severe illness. I like to listen to the patient’s story before I look at their wound, since the history will usually tell you the diagnosis.
His story was unusual, because he described the textbook onset of severe burning dysesthesia on his buttock after he was discharged and spending less time in his bed. Sure enough, the remaining open lesion on his buttock cheek was distributed in dermatomal pattern with the ones that had healed.
He had shingles. But you wouldn’t have missed that.

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