History:

This is a 45 year old lady who presented today with a painful weeping rash in the perianal area for a week. Started as a painful lesion with few blisters. She is in a same sex relationship. When I examined her today, there were no blisters but painful punctate lesions with erythematous surrounding and a sloughy base. She has never had these lesions before. I thought it was a bit too late to take viral swabs so I commenced treatment on clinical grounds.

Diagnosis: Genital herpes

Treatment: Valaciclorvir 500mg bd for10 days. patient advised to return if lesions recur. partner needs to be screened as well. she may be the carrier without any symptoms. Patient of Dr Kamlesh Das