Herpes simplex vegetans in a patient with primary myelofibrosis

Excerpt

A 45-year-old woman was admitted to our department with painless ulcerated plaque at the left labial angle. The lesion had developed several months ago and was slowly enlarging. Upon admission, she had already received several ineffective antibiotic pretreatments. The patient had a history of primary myelofibrosis diagnosed 1 year ago, and was treated with a combination of hydroxycarbamid and ruxolitinib. Physical examination revealed an ulcerated nodule, 1–2 cm in diameter, located on the left labial angle (Fig. 1). Laboratory examinations revealed leukocytosis (21⁹/L; normal range 4.4–11⁹/L), anaemia (haemoglobin 8.7 g/dL; 13.0–18.0 g/dL) and increased serum lactate dehydrogenase (1313 IU/L; normal range 10–250 IU/L). Cultures from lesional smears for fungi and bacteria were unremarkable, and testing for HIV was negative.

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