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small vesicle on a red base. Once established zoster can set up shop in a nerve and raise it's ugly head many years later along the distribution of that nerve with a condition called shingles.*** It is fortunate that vaccination, for the young or those over 60, prevents or reduces the severity in this often miserable condition.
• Blisters happen also from contact dermatitis when, for example, an allergy to nickel, poison ivy,*** antibiotic ointment develops, and that trigger comes in contact to skin. We also see blisters pop-up when unprotected hands are traumatized by raking the yard, burned by grabbing a hot pot handle, or frost-bitten*** on an ice-fishing expedition.
• A life-threatening blister condition may also occur when a person has an allergic reaction to some medicine, or even an infection, and blisters start spreading over extensive amounts of skin and into mucous membranes.*** Stopping the culprit medicine and providing urgent medical measures can save a life.
• My patient didn't fit any of these scenarios, however. I realized two other mysterious blistering conditions, called pemphigoid and pemphigus, might explain this, and so I made the brilliant diagnostic move to consult an expert. He biopsied the rash, nailed the diagnosis of pemphigoid,*** treated and cleared the blisters with just the right medicine, and my patient had relief. 
• The more I learn, the more I am humbled.
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• Dr. Rick Holm wrote this Prairie Doc Perspective for "On Call®," a weekly program where medical professionals discuss health concerns for the general public.  "On Call®" is produced by the Healing Words Foundation in association with the South Dakota State University Journalism Department. "On Call®" airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain. Visit us at OnCallTelevision.com. 
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