Hypertrophic herpes simplex simulating anal neoplasia in aids patients : Report of five cases

Five patients (4 males; mean age, 46.4 years) with painful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to rese...

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Bibliographic Details
Published in:	Diseases of the colon & rectum Vol. 48; no. 12; pp. 2289 - 2293
Main Authors:	NADAL, Sidney R, CALORE, Edenilson E, MANZIONE, Carmen R, HORTA, Sergio C, FERREIRA, Aurea F, ALMEIDA, Lis V
Format:	Journal Article
Language:	English
Published:	Secaucus, NJ Springer 01-12-2005 Lippincott Williams & Wilkins Ovid Technologies
Subjects:	Acquired Immunodeficiency Syndrome - complications Acyclovir - therapeutic use Adult Anal Canal - pathology Anus Neoplasms - complications Anus Neoplasms - diagnosis Biological and medical sciences Diagnosis, Differential Female Gastroenterology. Liver. Pancreas. Abdomen Herpes Simplex - complications Herpes Simplex - diagnosis Herpes Simplex - drug therapy Herpes Simplex - surgery Human viral diseases Humans Hypertrophy Immunohistochemistry Infectious diseases Inflammation Male Medical sciences Middle Aged Recurrence Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye Immunopathology Anal tumors Herpes AIDS Immune deficiency Infection Case study Herpes virus infection Anus Hypertrophic herpes simplex Viral disease Gastroenterology Tumor
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Summary:	Five patients (4 males; mean age, 46.4 years) with painful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, composed mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0012-3706 1530-0358
DOI:	10.1007/s10350-005-0188-4