Cunha, N

Serrão, V

Simões, P

Repositório do Centro Hospitalar de Lisboa Central, EPE

Revista Científica da Ordem dos Médicos          www.actamedicaportuguesa.com                                                                                                                587IMAGENS MÉDICASserology was consistent with treated syphilis. HIV load was 284 000 UI/mL, and CD4 cells were 14/mm3. Resolution of the ulcer was obtained after 28 days of oral acyclovir and reintroduction of antiretroviral therapy. In immunocompromised patients, HSV skin lesions can be larger, atypical, necrotic, and should be treated until complete resolution.1-3 Non-healing herpetic ulcers for longer than one month is an acquired immunodeficiency syndrome-defining condition.4Extensive Atypical HSV-2 Ulceration of the FingerÚlcera Digital Atípica Causada por HSV-21. Dermatology Department. Hospital de Santo António dos Capuchos. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.2. Department of Infectious Diseases. Hospital de Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal. Autor correspondente: Nélia Cunha. nelia.margarida.cunha@gmail.comRecebido: 21 de maio de 2017 - Aceite: 14 de julho de 2017 | Copyright © Ordem dos Médicos 2017Nélia CUNHA1, Pedro SIMÕES2, Vasco SERRÃO1Acta Med Port 2017 Jul-Aug;30(7-8):587-587  ▪  https://doi.org/10.20344/amp.9206 A 56-year-old man presented with a large and painful ulceration of the right first finger evolving for more than one month (Fig. 1). The patient had a known human immunodeficiency virus (HIV) infection for four years, but had discontinued antiretroviral treatment in the last year. Histological examination revealed balooning degeneration of keratinocytes. Immunohistochemical stain for herpes simplex virus (HSV) was positive (Fig. 2). HSV type 2 DNA was detected by polymerase chain reaction (PCR). Culture and PCR for mycobacteria were negative.  Syphilis Keywords: Acquired Immunodeficiency Syndrome; Fingers; Herpesvirus 2, Human; HIV; UlcerPalavras-chave: Dedos; Herpesvirus Humano 2 Síndrome de Imunodeficiência Adquirida; Úlcera; VIHREFERENCES1. Hogan MT. Cutaneous infections associated with HIV/AIDS. Dermatol Clin. 2006;24:473-95.2. Robayna MG, Herranz P, Rubio FA, Peña P, Peña JM, González J, et al. Destructive herpetic whitlow in AIDS: report of three cases. Br J Dermatol. 1997;137:812-5.3. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137.4. Centers for Disease Control and Prevention. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep. 1992;41:1-19. Figure 1 – Large and painful ulceration of the right first finger, evolving for more than one month Figure 2 – Immunohistochemical stain for herpes simplex virus (HSV) was positive

Úlcera Digital Atípica Causada por HSV-2

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Úlcera Digital Atípica Causada por HSV-2

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Repositório do Centro Hospitalar de Lisboa Central, EPE