Cytomegalovirus (CMV) rarely manifests as cutaneous lesions in immunocompromised patients. Only 25 cases have been reported since 1991. It causes latent infection among exposed individuals but reactivation may occur in immunocompromised patients causing encephalitis, pneumonitis, colitis, retinitis and congenital fetal infection. Cutaneous manifestations of CMV infection usually present with various skin lesions such as ulcers, erosions, erythematous morbilliform rash, vesicles and bullae. We report a case of cutaneous CMV infection in an HIV-AIDS patient presenting as a persistent ulcerated plaque on the nose. The lesion slowly evolved into a plaque which partially destroyed the right alar rim. Skin punch biopsy showed perivascular giant cells with large eosinophilic inclusions resembling an owl's eye consistent with CMV infection. He was subsequently diagnosed with CMV retinitis because of blurring of vision and findings of retinal necrosis on fundoscopy. Oral valganciclovir 1800mg/day was given for 21 days. Significant thinning and drying of the plaque with no further progression of ulceration of the alar rim were noted.

Human ; Male ; Adult ; Acquired Immunodeficiency Syndrome ; Blister ; Colitis ; Cytomegalovirus ; Cytomegalovirus Retinitis ; Encephalitis ; Exanthema ; Ganciclovir ; Immunocompromised Host ; Pneumonia ; Strigiformes ; Succinates ; Ulcer

Background: Virgin coconut oil (VCO) has been reported to have anti-inflammatory and anti-pruritic properties and can be used as an alternative to corticosteroids for mosquito bites. No studies on VCO for mosquito bites have been published. Objective: To compare the safety and efficacy of VCO against 1% Hydrocortisone as an anti-inflammatory and anti- pruritic preparation for mosquito bites. Method: This is a randomized, double-blind study comparing the anti-inflammatory and anti-pruritic effect of VCO versus 1% Hydrocortisone on Aedes aegypti bites, by measuring the mean lesion size, subjective assessment of the effects on bites, pruritus intensity through the visual analog, and verbal rating scale in 91 subjects at baseline, 1 hour, days 1, 3, and 7. Results: During the first hour and throughout the seven-day period, there was a decrease in the mean lesion size, visual, and verbal scale score for both VCO and Hydrocortisone groups. The mean lesion size for both groups were not statistically significant on the 1st and 24th hour. On day 3, the mean lesion size for the VCO group was 0.02 and 0.71 for the Hydrocortisone group which was statistically significant in favor of VCO. The mean visual and verbal scale scores for pruritus for both treatment groups were not statistically significant. As early as the 1st hour, the proportion of patients who reported total clearance of lesions in the VCO group was 34.09% compared to 6.38% in the Hydrocortisone group. On day 7, both treatment groups had resolution of lesions. No adverse reactions were noted. Conclusion Virgin coconut oil is safe, cost-effective, and comparable to 1% Hydrocortisone as an anti- inflammatory and anti-pruritic agent.
Coconut Oil ; Hydrocortisone ; Anti-Inflammatory Agents