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A Case Report : Recurrent Herpes Labialis In A 12 Year Old Boy Putu Mahadevy Pradnyandhari Putri; Ida Ayu Uttari Priyadarshini; Putu Ayu Paramitha Saraswaty
The International Journal of Medical Science and Health Research Vol. 7 No. 1 (2024): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/cqjtjb90

Abstract

Introduction: Herpes labialis, commonly known as cold sores, is an infection predominantly caused by herpes simplex type 1 (HSV-1).  Transmission of herpes labialis occurs through direct contact with active lesions or bodily fluids, including saliva, from infected individuals. Patients with herpes labialis often report prodromal symptoms before lesions appear, such as fever, fatigue, loss of appetite, and muscle aches. Localized symptoms, including pain, burning, or itching at the site of the impending eruption, are also common. This case report discusses a recurrent herpes labialis case at Wangaya Regional General Hospital, aiming to enhance understanding of the condition's presentation, management strategies to prevent recurrence, and measures to minimize transmission. Case Report : A 12-year-old boy was diagnosed with recurrent herpes labialis caused by an infection with herpes simplex virus type 1 (HSV-1). This diagnosis was based on the patient's medical history, which indicated prodromal symptoms and polymorphic lesions, as well as dermatological examination findings that showed herpetiform vesicles with crusting. The patient’s history of similar symptoms and the lesion’s localization to the vermillion border of the lips support the diagnosis of a recurrent infection. Herpes labialis is most commonly seen in children, particularly those under 19 years of age, which corresponds with the patient’s age. The primary risk factor is direct contact with an infected individual, which aligns with the patient's history of frequently sharing food and drinks with a friend who also exhibited similar symptoms. Additionally, the patient was known to share electronic cigarettes (vapes) with schoolmates. Recurrent herpes labialis can be triggered by various factors, including weakened immunity and UV exposure, both of which were present in this case.   Conclusion: The main treatment provided for this patient was oral acyclovir. The use of acyclovir aims to reduce symptoms, accelerate healing, and lower the risk of infection transmission. Acyclovir works by inhibiting viral replication through the suppression of DNA polymerase, which reduces the amount of active virus and speeds up recovery. The dosage of acyclovir given to the patient was in accordance with recommended guidelines. Supportive diagnostic tests, such as serology or Tzanck smear, are recommended to confirm the diagnosis. However, in this case, the diagnosis was already established through medical history and physical examination. Given that this is a contagious disease, the patient was educated on measures to reduce the risk of transmission.
Psoriasiform Digital Bowen’s Disease: A Diagnostic Challenge and Short-Term Response to Liquid Nitrogen Cryotherapy Putu Resika Melarosa; Ketut Kwartantaya Winaya; Lettisia Amanda Ruslan; Made Sri Adnyasitarini; Putu Ayu Paramitha Saraswaty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1513

Abstract

Background: Bowen’s disease (BD), or squamous cell carcinoma in situ, classically presents as a slowly enlarging erythematous plaque on sun-exposed skin. However, digital Bowen’s disease represents a distinct and rare clinical subset that frequently poses a significant diagnostic dilemma. Due to its unique anatomical location and morphological variability, digital BD often masquerades as benign inflammatory dermatoses, particularly psoriasis or chronic eczema, leading to dangerous therapeutic delays. Case presentation: We report the case of a 46-year-old male presenting with a solitary, rough, erythematous plaque on the dorsal aspect of the left index finger that had persisted for one year. The lesion was initially misdiagnosed and treated as an inflammatory condition without success. Detailed dermoscopic evaluation revealed a specific "psoriasiform" vascular pattern characterized by clustered glomerular vessels and surface scaling, raising suspicion for malignancy. Histopathological analysis confirmed the diagnosis of Bowen’s disease, demonstrating full-thickness epidermal atypia with psoriasiform hyperplasia. Notably, the presence of histological koilocytic atypia suggested a potential synergistic etiology involving Human Papillomavirus (HPV) infection alongside chronic ultraviolet exposure. The patient was treated with a tissue-sparing protocol of liquid nitrogen cryotherapy to preserve digital function. Conclusion: Complete clinical resolution of the lesion was observed at the three-week follow-up interval, resulting in a hypopigmented macule with full preservation of joint mobility. This case highlights the critical necessity of distinguishing "psoriasiform" malignancies from true inflammatory diseases through the recognition of specific vascular arrangements in dermoscopy. Furthermore, it suggests that cryotherapy is a pragmatic, function-sparing alternative to surgical excision for digital malignancies, provided that rigorous long-term surveillance is maintained to monitor for recurrence.
Psoriasiform Digital Bowen’s Disease: A Diagnostic Challenge and Short-Term Response to Liquid Nitrogen Cryotherapy Putu Resika Melarosa; Ketut Kwartantaya Winaya; Lettisia Amanda Ruslan; Made Sri Adnyasitarini; Putu Ayu Paramitha Saraswaty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1513

Abstract

Background: Bowen’s disease (BD), or squamous cell carcinoma in situ, classically presents as a slowly enlarging erythematous plaque on sun-exposed skin. However, digital Bowen’s disease represents a distinct and rare clinical subset that frequently poses a significant diagnostic dilemma. Due to its unique anatomical location and morphological variability, digital BD often masquerades as benign inflammatory dermatoses, particularly psoriasis or chronic eczema, leading to dangerous therapeutic delays. Case presentation: We report the case of a 46-year-old male presenting with a solitary, rough, erythematous plaque on the dorsal aspect of the left index finger that had persisted for one year. The lesion was initially misdiagnosed and treated as an inflammatory condition without success. Detailed dermoscopic evaluation revealed a specific "psoriasiform" vascular pattern characterized by clustered glomerular vessels and surface scaling, raising suspicion for malignancy. Histopathological analysis confirmed the diagnosis of Bowen’s disease, demonstrating full-thickness epidermal atypia with psoriasiform hyperplasia. Notably, the presence of histological koilocytic atypia suggested a potential synergistic etiology involving Human Papillomavirus (HPV) infection alongside chronic ultraviolet exposure. The patient was treated with a tissue-sparing protocol of liquid nitrogen cryotherapy to preserve digital function. Conclusion: Complete clinical resolution of the lesion was observed at the three-week follow-up interval, resulting in a hypopigmented macule with full preservation of joint mobility. This case highlights the critical necessity of distinguishing "psoriasiform" malignancies from true inflammatory diseases through the recognition of specific vascular arrangements in dermoscopy. Furthermore, it suggests that cryotherapy is a pragmatic, function-sparing alternative to surgical excision for digital malignancies, provided that rigorous long-term surveillance is maintained to monitor for recurrence.