A Protracted, Postherpetic Neuralgic Ulcer Treated with Risperidone and Intranasal Butorphanol.

Postherpetic neuralgia (PHN) represents a type of peripheral neuropathic pruritus that occurs after an episode of shingles and is characterized by localized pain, paresthesia, and itch, termed postherpetic itch (PHI); all may simultaneously exist within the same dermatomal distribution.1 Although PHI has been reported to affect up to 58% of patients with shingles,2 its exact pathophysiologic mechanism is poorly understood, and there are no proven specific treatments. Herein, we describe the case of a patient who presented with a painful and severely pruritic ulcer located on the left side of the neck that developed in the setting of PHN refractory to conventional treatments.