title: Inoculation herpes simplex virus infections in patients with AIDS: unusual appearance and location of lesions.
abstract: Two patients with AIDS developed protracted infection due to autoinoculation of herpes simplex virus in the great toe and the external ear, respectively, both unusual areas for inoculation. The appearances of the lesions were also unusual; severe hyperkeratosis was noted in both cases and a mass lesion in the external ear in one case. Both patients' conditions responded to acyclovir, although one patient required amputation of a digit due to intractable pain. In each case, the diagnosis was delayed despite the presence of mucocutaneous lesions, resulting in inappropriate treatment and prolonged discomfort. Inoculation disease due to herpes simplex virus should be suspected in patients with AIDS who have unusual skin lesions, particularly if oral and/or perianal lesions are also present.
authors.affiliation: Section of Infectious Diseases, Temple University Health Sciences Center, Philadelphia, Pennsylvania, USA.
authors.forename: G
authors.initials: G
authors.lastname: Weaver
authors.forename: J R
authors.initials: JR
authors.lastname: Kostman
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000473:pathology / Q000821:virology*; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D004423:Ear; D017809:Fatal Outcome; D006558:Herpes Genitalis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D006561:Herpes Simplex / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D014034:Toes; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir