You diagnose a patient with shingles involving the trigeminal nerve. Since there is involvement of the tip of the nose, you examine her thoroughly to exclude concurrent involvement of the:
- tympanic membrane
- nasal septum
- contralateral pinna
- ipsilateral epitrochlear node
This is Hutchinson's sign and suggests an involvement of the cornea with herpes. Ophthalmologic referral is indicated. (Fluorescein staining would show a dendritic lesion on the cornea).