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Two much Pain: A Patient with Painful Diabetic Neuropathy and Post Herpetic Neuralgia, a Case Report and Review

Tan GLC and Rosales RL

Contemporary data indicates that the prevalence of diabetes mellitus will increase by year 2030, where up to 50% develop neuropathy, and about a quarter will develop neuropathic pain. The purported immunocompromised diabetic state makes them also susceptible to various infections, for instance, herpes zoster infection. Presented in this report is a case of a 63 year old Filipino with painful diabetic neuropathy and who subsequently developed post herpetic neuralgia. A pain regimen with pregabalin initially at 150 mg/day ultimately reaching 600 mg/day reduced pains, but needed an augmentation with lidocaine patch (5%) application, and tramadol plus paracetamol fixed dose combination as rescue medication, for better control.