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Suggest treatment for persistent vaginal discharge and ulceration in the vulva

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Posted on Wed, 20 Jul 2016
Question: I am 50 years old and I am on truvada and alluvia. I have this vaginal discharge and ulceration that has been treated as herpes. It not improved despite many mo
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Answered by Dr. Albana Sejdini (2 hours later)
Brief Answer:
Need more details and a photo of ulceration as following....

Detailed Answer:
Hi my dear,

I have gone through your medical history carefully and understood your concern.

Can you please provide a photo of the ulceration you are having?
Have you done any test so far to confirm: herpes? or other stds (e.g. gonorrhea? chlamydia?)

Any swab culture or testing for stds or biopsy of the ulceration?
Can you please also provide the names of the drugs you've been using to treat this ulceration orally and/or locally?

As you are HIV positive, you are taking truvada and aluvia. Unfortunately, these drugs cannot cure the ulceration.

Looking forward to have the requested info and photo in to help you further.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Albana Sejdini (2 days later)
Hello Doctor,

I have been on acyclovir since 1986. Both the high dose and the prophylactic does. But it goes and comes back. I have also taken the second line antiviral (I don't remember it's name). I am now on Thalidomide 1 capsule daily. It appeared that this gave it some relief for two weeks it has now come with a vengeance. I don't know what to do.

I am still taking the thalidomide.

I can't take a picture now because I am uncomfortable doing that. But it starts with the prodrome I get the tingling and then the ulceratiom starts. I am in sanitary towels at least 9 out of 12 months.

doctor
Answered by Dr. Albana Sejdini (2 days later)
Brief Answer:
Biopsy of ulceration advised...

Detailed Answer:
Hi back my dear,

Sorry for the late reply.

I am also sorry to know that you can't provide the photo.
That could have helped more.

However, as the ulceration is not getting better, I'd advise biopsy to determine the right causative factor and treat it correctly.

Please take note, that being HIV positive makes you more prone to infection due to low immune system/defense. Furthermore, it will take a few more time to get completely healed, more than for other non-HIV-positive persons.

Wish fast recovery!
Dr.Albana

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini (36 minutes later)
Thank you for the response. The lesion has been severally been biopsied and it shows chronic non-specific inflammation. It shows no new growth or cancer cells. Besides my viral load is undetectable and my CD 4 count is 800. I don't understand why it should persist.
doctor
Answered by Dr. Albana Sejdini (18 minutes later)
Brief Answer:
ok,can you send the full biopsy report?

Detailed Answer:
Hi back,

Ok, then, can you please send the full biopsy report to? And can you mention all meds you have specifically used for the ulceration (orally or locally)? Try to send a photo to me.

If ulceration persists, then, should revise the treatment and change treatment strategy.

If I was your caring doctor would specify if the ulceration is really herpetic or bacterial in order to suggest appropriate treatment.

Thank you!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Albana Sejdini

General & Family Physician

Practicing since :2006

Answered : 7218 Questions

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Suggest treatment for persistent vaginal discharge and ulceration in the vulva

Brief Answer: Need more details and a photo of ulceration as following.... Detailed Answer: Hi my dear, I have gone through your medical history carefully and understood your concern. Can you please provide a photo of the ulceration you are having? Have you done any test so far to confirm: herpes? or other stds (e.g. gonorrhea? chlamydia?) Any swab culture or testing for stds or biopsy of the ulceration? Can you please also provide the names of the drugs you've been using to treat this ulceration orally and/or locally? As you are HIV positive, you are taking truvada and aluvia. Unfortunately, these drugs cannot cure the ulceration. Looking forward to have the requested info and photo in to help you further. Dr.Albana