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October 1, 2015: Hutchinson’s Sign

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October 1, 2015

Hutchinson’s Sign

Hutchinson’s sign is the presence of vesicular lesions on the side or tip of the nose. It is classically associated with acute herpes zoster ophthalmicus, which may cause loss of vision, ocular inflammation, and debilitating pain. The location of the lesions results from herpes zoster reactivation involving the nasociliary nerve, a branch of the ophthalmic division of the trigeminal nerve that innervates the cornea and the lateral dorsum and tip of the nose. Patients with Hutchinson’s sign should be treated with acyclovir and referred emergently to ophthalmology for evaluation of herpes zoster ophthalmicus.

  1. Zaal MJ, Volker-Dieben HJ, and D’Amaro J. Prognostic value of Hutchinson’s sign in acute herpes zoster ophthalmicus. Graefe’s Arch Clin Exp Ophthalmol 2003; 241:187–191.

Submitted by Meagan Seay, DO, PGY-2 Neurology Resident, Cleveland Clinic.

Disclosures: Dr. Seay reports no disclosures.

For more clinical pearls and other articles of interest to neurology trainees, visit Neurology. Listen to this week's Neurology Podcast.

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