Kn Shivaswamy

High seroprevalence of HSV-1 and HSV-2 in STD clinic attendees and non-high risk controls: a case control study at a referral hospital in south India.

BACKGROUND In Asia, HSV seroprevalence studies are sparse and they have recorded lower prevalence of HSV infection, especially HSV-2. AIMS To ascertain the seroprevalence of HSV-1 and HSV-2 in patients attending a STD clinic in a referral hospital in south India and to compare it with a control group. METHODS The study included 135 consecutive STD cases having history of ulcerative or non-ulcerative STD in the present or in the past 5 years and 135 age and sex-matched controls. Diagnostic serology was done for HSV-1 and HSV-2 using type specific IgG by indirect immunoassay using ELISA. The results were analyzed utilizing Chi- square test. RESULTS Amongst 135 STD clinic cases, 106 cases were males and 29 cases were females with male to female ratio of 3.65:1. The mean age was 32.2 years (range 16-65 years). Among study group cases, 112 (82.9%) cases were co-infected with HSV-1 and HSV-2, 11 (8.1%) cases were seropositive for HSV-1 alone and 3 (2.2%) cases were seropositive for HSV-2 alone. In the control group, 112 (82.9%) cases were co-infected with HSV-1 and 2, 12 (9.6%) for HSV-1 alone and 1(0.8%) for HSV-2 alone. Correlation of HSV-1 and HSV-2 serology with various demographic and behavioral factors was statistically insignificant. CONCLUSIONS Seroprevalence of HSV-1 and HSV-2 in STD clinic cases and control group is high, similar to that recorded in sub-Saharan Africa. Thus, serological studies for HSV-1 and HSV-2 cannot be taken as a marker of sexual behavior in our set of population.

Subcorneal pustular dermatosis and thymoma: An association or a coincidence?

A 36-year-old male came to us with a six months history of a generalized, itchy, pus-filled eruption and a change in voice of five months duration. Healthy looking male on cutaneous examination revealed numerous isolated and grouped vesicles and vesiculopustules ranging from 5-10 mm on both normal and erythematous skin over the face, trunk, buttocks and extremities. Both flaccid and tense vesicles were seen along with some of them coalescing to form circinate or polycyclic patterns with crusting. Most of these lesions showed hypopyon formation. Nikolskys sign and bulla-spread sign were negative. Histopathology and direct immunofluorescence substantiated our clinical diagnosis of subcorneal pustular dermatosis (SCPD). On investigation, he was found to have thymoma. We herewith report an association of SCPD with thymoma in this case report, not yet reported in the literature.