Pseudotumoral Chronic Genital Herpes Mimicking Squamous Cell Carcinoma: A Case Report

Abstract

M. Hammouch*, H. Rachadi, F. Anejjar and S. Chiheb

Background: Genital herpes is a common sexually transmitted infection, usually caused by herpes simplex virus type 2 (HSV- 2). In immunocompromised patients, especially those living with HIV, chronic and atypical presentations can mimic neoplastic lesions.

Case Presentation: We report a 48-year-old HIV-positive male with a 7-month history of an ulcerative-vegetative lesion on the glans. Antiretroviral therapy had been interrupted for one year, resulting in elevated viral load. Initial biopsies suggested no malignancy. The lesion worsened after corticosteroid therapy for suspected pyoderma gangrenosum. Cytodiagnosis (Tzanck smear) confirmed herpes simplex virus infection. Intravenous acyclovir combined with topical imiquimod and resumption of antiretroviral therapy led to rapid clinical improvement and normalization of viral load and CD4+ count.

Conclusion: Pseudotumoral chronic genital herpes is a rare but important differential diagnosis for genital lesions in immunocompromised patients. Early recognition and appropriate antiviral therapy, along with immune restoration, are essential for lesion resolution and prevention of recurrence.

HTML PDF