Exophytic Ulcerated Tumors in HIV Patients: Diagnostic and Therapeutic Problems

Lautenschlager, Stephan; Schwarzkopf, Stefan; Keller, Beat

doi:10.1159/000109360

Cited by 21 publications

(28 citation statements)

References 52 publications

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“…Our patient had a very low CD4 count at diagnosis (13 cells/uL) which was raised to more than 200 cells/uL with HAART. Although median time interval from initiating HAART to IRIS from previous reports was approximately 3–5 months (range, 2–12), a few cases occurred even prior to HAART or as late as several years . This was also observed in our patient who developed IRIS 2 years after HAART.…”

Section: Discussionsupporting

confidence: 69%

“…Recurrent cervical cancer or a new human papilloma virus‐related vulvar cancer was the provisional diagnosis in our patient. Differential diagnoses of verrucous growth in a HIV infected individual are squamous cell carcinoma and lesions caused by opportunistic infection such as condylomata acuminata, condylomata lata, varicella zoster or CMV . An oncologist should keep these differential diagnoses in mind in order not to treat any mass lesions in an immunocompromised patient as cancer until proven pathologically .…”

Section: Discussionmentioning

confidence: 99%

“…We did not perform tissue culture and sensitivity test because none of second‐line anti‐viral drugs are available in our country. Topical imiquimod is an immuno‐modifying agent and was reported to be successful in a few cases of HSV inducing PEH . The agent was added to oral acyclovir resulting in partial response.…”

Section: Discussionmentioning

confidence: 99%

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Vulvar pseudoepitheliomatous hyperplasia associated with herpes simplex virus type II mimicking cancer in an immunocompromised patient

Tangjitgamol

Loharamtaweethong

Thawaramara

et al. 2013

J of Obstet and Gynaecol

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We report an exaggerated dermatological inflammatory condition in an immunocompromised patient. The patient was a 51-year-old woman who had HIV infection and a history of cervical cancer. Three years after highly active antiretroviral therapy with an improved immune status, and 2 years after remission of cervical cancer, she developed verrucous perineal masses. Provisional diagnosis was recurrent cervical cancer or primary vulvar cancer. Pathological features revealed pseudoepitheliomatous hyperplasia associated with herpes viral infection. After minimal response to systemic oral antiviral drugs and topical imiquimod, she had clinical resolution with the addition of systemic oral corticosteroid.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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Vulvar pseudoepitheliomatous hyperplasia associated with herpes simplex virus type II mimicking cancer in an immunocompromised patient

Tangjitgamol

Loharamtaweethong

Thawaramara

et al. 2013

J of Obstet and Gynaecol

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“…2 There are reports in the literature of genital herpes with an atypical clinical presentation that mimics a neoplastic rather than infectious process. 3 The lesions can disseminate and occur at multiple sites, including atypical locations such as buttocks, abdomen, and lower back. The severity of the clinical presentation and the duration usually correlates with the degree of immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

“…The severity of the clinical presentation and the duration usually correlates with the degree of immunosuppression. 3 …”

Section: Introductionmentioning

confidence: 99%

Atypical Presentation of Exophytic Herpes Simplex Virus Type 2 With Concurrent Cytomegalovirus Infection

Garib

Hughey

Elmets

et al. 2013

The American Journal of Dermatopathology

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We report 3 unusual cases of atypical exophytic cutaneous herpes simplex virus (HSV) type 2 with concurrent cytomegalovirus (CMV) infection in immunosuppressed patients and raise awareness to the significant clinical and pathologic challenges in establishing the correct diagnosis. In all the 3 cases, the lesions presented as fungating plaques and nodules with areas of superficial erosion. Initial clinical differential included genital warts, syphilis, versus cutaneous malignancy. All the 3 patients were referred to the dermatology clinic where a combination of cutaneous biopsies, viral cultures of the lesions, polymerase chain reaction, CMV antigenemia, and immunoperoxidase stains for CMV and HSV confirmed the diagnosis of HSV type 2 with concurrent CMV infection. All the 3 patients were treated with oral valganciclovir with significant improvement noted at the follow-up visit. In addition, we review the previously reported HSV/CMV cutaneous coinfection cases.

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Cutaneous perianal herpes simplex virus infection mimicking condylomata acuminata in a renal transplant recipient: A case report and literature review

Al‐Zubaidi,

Gholizadeh

et al. 2024

Clinical Case Reports

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Key Clinical MessageHerpes simplex virus (HSV) infection can present atypically in immunosuppressed patients, such as renal transplant recipients, often mimicking conditions like condyloma acuminata. This case report of a 39‐year‐old male renal transplant recipient underscores the importance of maintaining a high level of clinical suspicion and employing thorough diagnostic techniques, including skin biopsy and polymerase chain reaction, to accurately diagnose chronic lesions and those not responding to initial therapies in these patients. Timely initiation of antiviral therapy, such as intravenous acyclovir, is crucial for improving patient outcomes. Clinicians should be aware of the diverse presentations of HSV in immunocompromised individuals to ensure prompt and effective treatment.AbstractHerpes simplex virus (HSV) has a worldwide distribution and a wide range of clinical presentations. In immunosuppressed patients, the infection can have atypical presentations. We report a 39‐year‐old renal transplant recipient male with a cutaneous HSV infection mimicking condyloma acuminata. The diagnosis was confirmed by skin biopsy and polymerase chain reaction. The patient was treated with intravenous acyclovir. This case illustrates the significant clinical challenges in establishing a correct diagnosis of this common infection in these patients. A high level of clinical suspicion will result in a prompt diagnosis and timely initiation of antiviral therapy, which is crucial to better patient outcomes.

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Exophytic Ulcerated Tumors in HIV Patients: Diagnostic and Therapeutic Problems

Cited by 21 publications

References 52 publications

Vulvar pseudoepitheliomatous hyperplasia associated with herpes simplex virus type II mimicking cancer in an immunocompromised patient

Vulvar pseudoepitheliomatous hyperplasia associated with herpes simplex virus type II mimicking cancer in an immunocompromised patient

Atypical Presentation of Exophytic Herpes Simplex Virus Type 2 With Concurrent Cytomegalovirus Infection

Cutaneous perianal herpes simplex virus infection mimicking condylomata acuminata in a renal transplant recipient: A case report and literature review

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