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Elderly woman with headache
  1. Kuo-Chang Lee,
  2. Wei-Jing Lee
  1. Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan
  1. Correspondence to Dr Wei-Jing Lee, Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan; saab931103{at}

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Clinical introduction

A 68-year-old woman with medical history of hypertension, chronic kidney disease and adrenal insufficiency, presented to the ED with progressive headache and left side facial pain for 2 days. Left eye tearing, tinnitus and otalgia were newly developed symptoms for 1 day. Examination of the tongue showed multiple vesicles and pustules on anterior two-thirds of the left side tongue (figure 1). No abnormality was noted in her blood lab test.

Figure 1

Image of the tongue: multiple …

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  • Handling editor Ellen J Weber

  • Correction notice This paper has been updated since first published. In the answer part of this Image challenge, the correct answer option was mistakenly listed as ‘D. Tongue Cancer’. It has now been revised to the correct answer which is ‘C. Lingual herpes zoster’.

  • Contributors My colleague and I provide equal contribution.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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