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1. CASE REPORT
Dr Zain Latif
PG D-Derm

2. BIODATA
 NAME: Muhammad Rafique
 AGE: 18 year
 SEX: Male
 RESIDENT: Karachi
 unmarried
 Come in OPD in 7th feb 2018

3. Presenting Complain:
 Single group filled with fluid on shaft of penis since
2 month

4. HISTORY OF PRESENTING
COMPLAIN
 According to my patient, the patient was alright 2 months
back until he noticed some filled with fluid on shaft of penis.
 First appeared on the shaft of penis.
 Fluid filled and rapture easily themselves
 Associated with mild pain and itching
 No Fever
 No Dysuria

5. PAST HISTORY
 PAST MEDICAL HISTORY
 PAST SURGICAL HISTORY
 NOT SIGNIFICANT

6. DRUG HISTORY
 Co-Amoxiclav 625MG 1XBD 1 WEEK
 Topical antiviral

7. FAMILY HISTORY
 His father is hypertensive and diabetic
 No skin disease in family

8. PERSONAL HISTORY
 Sleep Normal
 Appetite Normal
 Bowel habits Normal
 No Addiction

9. GENERAL PHYSICAL
EXAMINATION
 A Young aged Boy of average height and build sitting
comfortably well oriented to place and person
Vitals
 Heart rate: 90 beats/mim
 Resp rate: 19breaths/min
 Temperature: 99 F
 Blood pressure: 110/80mmhg

10. SUBVITALS
 PALLOR -VE
 EDEMA -VE
 JAUNDICE -VE
 CLUBBING -VE
 CYANOSIS -VE
 KOILONCHIA -VE
 LYMPH NODES NOT enlarge

11. CUTANEOUS EXAMINATION
 Multiple vesicle at the shaft of penis on erythematous base
 Filled with Clear fluid
 Niksolky sign negative

12. DIFFERENTIAL DIAGNOSIS

13. DIFFERENTIAL DIAGNOSIS
 Genital herpes
 Pearly Penile Papules
 ALLERGIC CONTACT DERMATITIS

14. Pearly Penile Papules

15. ALLERGIC CONTACT
DERMATITIS

16. INVESTIGATION
 CBC
 URINE D/R
 HBsAg
 Anti-hcv
 VDRL
 HIV

17. INVESTIGATIONS
CBC Normal
Urine d/r Normal
VDRL (Non Reactive)

18. INVESTIGATIONS
 HIV HUMAN IMMUNODEF. VIRUS ANTIBODY
 HIV Ag/AB (Non – Reactive 028)

19. INVESTIGATIONS
 HBsAg (Non Reactive 0.13)
 Anti-Hcv (Non Reactive 0.32)

20. TREATMENT WE GAVE

21. FINAL DIAGNOSIS
 Gentiles herpes

22. Investigation
• Cultrue :
from vesicles fluid
 Immunoflurescence
In scrapings from lesions

23. HERPES GENITAL
 Infection of the Genital Skin and Mucous membrane.
 Herpes Simplex
* Type 1 : Facial Infections, ( Increase frequency : HSV
 Herpes Gental
* Type 2 : Genital Infections (Commonly Symptomatic
• Acquired by :
* Direct Contact
* Droplets
* Infected secretions via Skin or Mucosa
 Type 2 : Transmitted sexually

24. EPIDEMIOLOGY
 Genital herpes is usually transmitted sexually. Studies have
found that up to 1 in 5 adults have evidence of HSV-2
infection. Most of these people have either no or only very
mild symptoms, such that they are unaware of having been
infected.
 Age: type 2 infection occur mainly after puberty. In children
with genital herpes (HSV-1 or HSV 2), sexual abuse must be
considered.

25. Clinical Features
 Primary Infection :
 in a previously seronegative individual
• In Men:
• Penile ulceration (common),Sore & Painful
• On the glans, prepuce and shaft of the penis
• In MSM: Common in the perianal area
May extend into the rectum
• In Women: Vulva, vagina and cervix

26. Symptoms
 Break outs of blisters, chancres, and tender ulcers
 More serious cases affect the eye and central
nervous system
 First outbreak usually occurs within 2 weeks of exposure
 May also include flu-like symptoms
 Frequency decreases overtime (4-5 within a year)

27. Transmission
 Contact with ruptured sores
 Skin to skin contact
 Sexual contact

28. Transmission
 Can occur between outbreaks
 Skin may contain virus without sores (small rash)
 HSV-2 Genital to Genital
 HSV-1 Oral to Oral, Hand to Oral, Oral to Genital

29. Diagnosis
 Viral culture or Blood Test
 Serological Blood test best - Tests antibodies

30. Complication
 Sacral paraesthesia
 Urinary retention
 Constipation
 Impotence
 Encephalitis

31. Treatment

32. Prevention
 Use of condoms
 Abstinence