title: Cutaneous lumbosacral Herpes simplex virus among patients hospitalized for an advanced disease.
abstract: BACKGROUND
  Cutaneous Herpes simplex virus (HSV) infections are regularly observed in lumbosacral areas, and many are refractory to appropriate initial diagnosis and management.
  
  
  OBJECTIVE
  We aimed to evaluate the incidence of lumbosacral HSV among advanced disease patients, to estimate their survival index from HSV onset, and to describe their clinical and virological characteristics.
  
  
  METHODS
  A prospective, descriptive study was conducted in a palliative and continuous care centre, collecting patients with suspected cutaneous HSV lesions in the lumbosacral area.
  
  
  RESULTS
  From 2008 to 2010, 24 patients were included: 19 had HSV-2 confirmed by at least one laboratory test. Incidence of HSV-2 was 2.67% (1.73-4.33%, 95% CI). No age, gender or survival differences were observed compared to the global population in the centre. Most lesions were detected early as vesicles (14/24) or small ulcers. Sensitivity was good for all diagnostic methods (62.5% for immunofluorescence and 79.2% for culture and/or PCR). Outcome was favourable under classical antiherpetic drugs and topical antiseptic dressing.
  
  
  CONCLUSIONS
  Cutaneous lumbosacral HSV remains uncommon in patients hospitalized with advanced diseases. Most of these patients suffer from pressure ulcers or other dermatitis; we advocate increased attention of this diagnosis to avoid skin complications and added pain.
authors.affiliation: Division of Dermatology, University Hospital Geneva, Geneva, Switzerland. laurence.trellu@hcuge.ch
authors.forename: L
authors.initials: L
authors.lastname: Toutous-Trellu
authors.forename: K M
authors.initials: KM
authors.lastname: Vantieghem
authors.forename: K
authors.initials: K
authors.lastname: Terumalai
authors.forename: F R
authors.initials: FR
authors.lastname: Herrmann
authors.forename: V
authors.initials: V
authors.lastname: Piguet
authors.forename: L
authors.initials: L
authors.lastname: Kaiser
authors.forename: H
authors.initials: H
authors.lastname: Vuagnat
authors.forename: G
authors.initials: G
authors.lastname: Zulian
mesh_terms: D000368:Aged; D001483:Base Sequence; D017931:DNA Primers; D005260:Female; D006561:Herpes Simplex / Q000628:therapy*; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012447:Sacrum; D017193:Skin Diseases, Viral / Q000628:therapy* / Q000821:virology
chemical_list: D017931:DNA Primers