Genital Herpes in Immunocompromised.

Genital herpes are a frequently encountered genital ulcer, and, the large non healing ulcers at anogenital areas commonly  elicits the suspicion of  immunocompromise state, but till date, there is no clear description of these herpetic ulcers to  differentiate it from the classical herpetic ulcer and other  ulcers.

Herpetic ulcers are thought to have the diverse clinical presentation, in both normal and immunocompromised cases, but, my observation in   seven cases of herpetic ulcers in HIV positive case is that, these  ulcers usually single, large (composed of small herpetic ulcers) with uniform depth all through and punched out arcuate border. This uniform depth  and the  non healing nature of the ulcer could be possibly due cytopathic damage of the keratinocytes by herpes virus and due to frequent recurrence preventing. I presume the description like deep, necrotic, and phagedenic form  is not possible even in AIDS unless there is a superimposed  secondary infection, as herpes virus will only attack keratinocytes not any other cells.

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