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Chronic Ulcerative Herpes Simplex Virus Infection of the VulvaGriffith-Bauer K.a · O’Hearn M.b · Ehst B.D.a
Departments of aDermatology and bMedicine, Oregon Health & Science University, Portland, Oreg., USA Corresponding Author
Dr Benjamin D. Ehst
Department of Dermatology
Oregon Health & Science University, Mail Code CH16D
3303 SW Bond Avenue, Portland, OR 97239 (USA)
Herpes simplex virus infections in HIV-infected individuals can be clinically unusual and difficult to treat due to underlying problems with cell-mediated immunity and the occurrence of antiviral resistance. Additionally, partial or incomplete restoration of immune function may result in chronic ulcerations that require rotational treatments. In this report, we describe the case of a 38-year-old HIV-positive woman who developed the ulcerative form of chronic herpes simplex infection despite highly active antiretroviral therapy and valacyclovir prophylaxis. Repeated intravenous courses of foscarnet and topical cidofovir finally controlled her erosions as her cell-mediated immunity was slowly restored. This case highlights the challenges that still exist in diagnosing and managing this rare presentation of herpes simplex virus
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