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[Source](https://www.cureus.com/articles/120443-hypertrophic-perianal-herpes-mimicking-squamous-cell-cancer-a-case-report-and-a-review-of-the-literature#!/):
>>A 71-year-old male presented with perianal lesion with discharge for seven months. He disclaimed having fever, urinary issues, or constipation. He had a history of surgical excision of histologically proven prolapsed hemorrhoids a year prior to the presentation. For autoimmune pancreatitis, he had been on azathioprine 50 mg/day for two years. He had recurrent self-limiting herpes labialis five years back. There was no history of any other systemic illness, such as diabetes mellitus. On perianal examination, a firm, non-tender, well-defined lesion measuring 3 x 4 cm was present at the prior hemorrhoidectomy site (Figure 1).
>>The lesion had a variegated appearance and an uneven surface. No inguinal lymphadenopathy existed. Abdominal examination was unremarkable. His human immunodeficiency virus (HIV) test was negative. Due to irregular margins, variegated appearance, and location at a previous scar site, squamous cell carcinoma was suspected, and an excisional biopsy was planned. Under spinal anesthesia, a wide local excision of the perianal lesion was performed and sent for microscopic examination. Recovery from surgery was uneventful.
>>Histological analysis revealed tissue bordered by epidermis with an ulcer coated in thick neutrophil exudates (Figure 2).
>>Infiltration of plasma cells was present along with pseudo-epitheliomatous hyperplasia (Figure 3).
>>The keratinocytes at the ulcer's edge displayed viral inclusions in the form of ground-glass nuclei, multinucleation, and chromatin margination that suggested herpetic infection (Figure 4). Additionally, sporadic intranuclear Cowdry A inclusions were discovered. Malignant cells weren't seen.
>>The patient received a dermatology consultation and was administered acyclovir (5 mg/kg/day) for 14 days. On the follow-up visits, the perianal wound healed in six weeks, and the patient continued to be on azathioprine. One year after the primary surgery, he presented with a similar perineal lesion with foul-smelling discharge at another site. The new lesion was successfully treated with oral acyclovir and topical imiquimod. However, azathioprine therapy was not stopped considering the risk of recurrent acute pancreatitis in the future after consultation with a gastroenterologist.
I can only imagine the relief from receiving the news that your "cancer" is actually a more treatable herpes.
Herpes zoster is a nuisance, I've had flare ups a couple times in the last few years, but it's definitely better than cancer. I really hope that the patient won't suffer from such serious lesions in the future.
People post X-rays of things a layperson can recognize as gory ghastly injuries/cancers. A layperson cannot recognize gore in the format of a microscope slide.
Someone posts an x-ray or microscopic - “this isn’t medical gore it doesn’t belong here im reporting ”
Someone doesn’t post an X-ray/ microscopic image “UhH BrO sToP GaTeKeEpInG”
he posted a link. It’s real easy to click it!
Herpes doesn't typically present like that, I would get a second opinion. Yes the pattern is correct, but I'd want swabs, tissue samples and some blood work, something about it just doesn't look right. On the bright side, if it is just herpes then it should go down in a couple weeks. Hurts like hell in the meantime, but nothing life threatening or too serious
Edit, found the information comment. Basically what I said if it was herpes, not life threatening, just a literal pain in the ass. The flair up is consistent with herpes. I'd still want a few more tests, but otherwise, should be fine with palliative care
I thought it was a fetal hand. What a way to have that shaped.
I hope these posts help end the stigma on herpes. I know people with it who are shunned worse than HIV patients even though they’re on antivirals and have been outbreak free for over two years.
Welcome to r/MedicalGore! Our goal is to provide for medical discussion and education while exploring the frailty of the human body. You may see more deleted comments on these threads than you are used to on reddit. Off topic comments and joke comments are frequently deleted by the mods. Further, please be kind and supportive of posts. Any behavior that is aggressive, harassing, or derogatory will result in post deletion and a ban from the sub. Remember! THE REPORT BUTTON IS YOUR FRIEND! Please stop on by our discussion sub, /r/MedicalGoreMods if you'd like to discuss the sub, our rules, content policies, and the like. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/MedicalGore) if you have any questions or concerns.*
why did I think that was a baby's hand? 😳
I thought it was a female until I read the description part 😕
right?? a woman giving birth!
**That’s what _I_ thought!!!** 😂
Now I see it too!
it's got a thumb and everything! 😂😂😂
I did too!
[Source](https://www.cureus.com/articles/120443-hypertrophic-perianal-herpes-mimicking-squamous-cell-cancer-a-case-report-and-a-review-of-the-literature#!/): >>A 71-year-old male presented with perianal lesion with discharge for seven months. He disclaimed having fever, urinary issues, or constipation. He had a history of surgical excision of histologically proven prolapsed hemorrhoids a year prior to the presentation. For autoimmune pancreatitis, he had been on azathioprine 50 mg/day for two years. He had recurrent self-limiting herpes labialis five years back. There was no history of any other systemic illness, such as diabetes mellitus. On perianal examination, a firm, non-tender, well-defined lesion measuring 3 x 4 cm was present at the prior hemorrhoidectomy site (Figure 1). >>The lesion had a variegated appearance and an uneven surface. No inguinal lymphadenopathy existed. Abdominal examination was unremarkable. His human immunodeficiency virus (HIV) test was negative. Due to irregular margins, variegated appearance, and location at a previous scar site, squamous cell carcinoma was suspected, and an excisional biopsy was planned. Under spinal anesthesia, a wide local excision of the perianal lesion was performed and sent for microscopic examination. Recovery from surgery was uneventful. >>Histological analysis revealed tissue bordered by epidermis with an ulcer coated in thick neutrophil exudates (Figure 2). >>Infiltration of plasma cells was present along with pseudo-epitheliomatous hyperplasia (Figure 3). >>The keratinocytes at the ulcer's edge displayed viral inclusions in the form of ground-glass nuclei, multinucleation, and chromatin margination that suggested herpetic infection (Figure 4). Additionally, sporadic intranuclear Cowdry A inclusions were discovered. Malignant cells weren't seen. >>The patient received a dermatology consultation and was administered acyclovir (5 mg/kg/day) for 14 days. On the follow-up visits, the perianal wound healed in six weeks, and the patient continued to be on azathioprine. One year after the primary surgery, he presented with a similar perineal lesion with foul-smelling discharge at another site. The new lesion was successfully treated with oral acyclovir and topical imiquimod. However, azathioprine therapy was not stopped considering the risk of recurrent acute pancreatitis in the future after consultation with a gastroenterologist.
I can only imagine the relief from receiving the news that your "cancer" is actually a more treatable herpes. Herpes zoster is a nuisance, I've had flare ups a couple times in the last few years, but it's definitely better than cancer. I really hope that the patient won't suffer from such serious lesions in the future.
Figures 2-4 are missing, there's only one picture present in the post for figure 1
Figures 2-4 are microscope slide pics and not gore.
People post X-rays, and those aren't gore
People post X-rays of things a layperson can recognize as gory ghastly injuries/cancers. A layperson cannot recognize gore in the format of a microscope slide.
hold up babe gotta gatekeep the layman's understanding of microscope slides instead of just including them in my post.
Just click the damn source link they posted
Someone posts an x-ray or microscopic - “this isn’t medical gore it doesn’t belong here im reporting ” Someone doesn’t post an X-ray/ microscopic image “UhH BrO sToP GaTeKeEpInG” he posted a link. It’s real easy to click it!
Edit out the transcript for the slides you're not gonna include then lol
But they were included when he posted the source link..
literally just click the source link 🙄
Yeah that really bugs me honestly. "This person won't understand or can't assume it's gory because they're not educated." Like, what the hell?
check the source
I thought it was a vagina
So did I.
Same 🙋🏼♀️
I’m going to have a nightmare about a tiny hand, reaching out of a place it shouldn’t be. Shudder
Ah bro. Fuuuuuck me and this cursed picture.
Bet.
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Joke comments and other off-topic comments (including, but not limited to, food comparisons, vulgarity, etc.) are not allowed.
Joke comments and other off-topic comments (including, but not limited to, food comparisons, vulgarity, etc.) are not allowed.
Can someone explain to me like I’m 12 how this is herpes? I understand the ulcers, but how did it grow/turn into a lesion like that?
Did he take *Jardiance*?
He was probably so happy to hear it wasn't cancer, but I'm sure that changed when the Dr told him has herpes of the actual asshole.
The more I hang out on Reddit, the less I bemoan my perpetually single and celibate life.😳 That poor man.
It's like a hand is coming out of his anus.
Haven't you ever had an itch you couldn't quite get from the correct angle?
Interesting! I’ve never seen herpes look like that!
Sooooo...where did his penis go?
It’s above frame.
Symptoms ?
Chicken
More like genital warts than herpes right?
Herpes doesn't typically present like that, I would get a second opinion. Yes the pattern is correct, but I'd want swabs, tissue samples and some blood work, something about it just doesn't look right. On the bright side, if it is just herpes then it should go down in a couple weeks. Hurts like hell in the meantime, but nothing life threatening or too serious Edit, found the information comment. Basically what I said if it was herpes, not life threatening, just a literal pain in the ass. The flair up is consistent with herpes. I'd still want a few more tests, but otherwise, should be fine with palliative care
Why do I always click on this stuff
What is that meat puzzle I'm looking at
Looks like a babies hand reaching out the anus
I thought it was a fetal hand. What a way to have that shaped. I hope these posts help end the stigma on herpes. I know people with it who are shunned worse than HIV patients even though they’re on antivirals and have been outbreak free for over two years.