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A 70-year-old white female presents with a pruritic rash on her sacrum that has occurred intermittently over the last 6 years. She reports that the area is always very tender just before the blister-like lesions erupt. She is otherwise in good health, and takes no medications. Her past medical history is unremarkable. You provide appropriate treatment for the condition. You should advise the patient to avoid which one of the following during future outbreaks?
A. Excessive intake of green, leafy vegetables
B. Sexual contact
C. Perfumed soaps or body lotions
D. Sun exposure
E. Prolonged sitting
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ht u r right but 70 doesnt mean she was not sex. active.need more info
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u r right ht and the lesions on sacrum
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B
Genital herpes is the most common sexually transmitted genital ulcer disease in the U.S. It can occur at any age, and data suggest that it may be the most common sexually transmitted disease in women over the age of 50 years. Extragenital sites are involved in one-fourth of infected women, and the sacrum and buttocks are frequent locations. Sacral nerve innervation from the vaginal area provides a pathway for the virus. Prevention of transmission depends upon cogent patient education advising abstinence from skin-to-skin contact when active lesions are present. Ref: Rivlin ME, Martin RW (eds): Manual of Clinical Problems in Obstetrics and Gynecology, ed 5. Lippincott, Williams & Wilkins, 2000, pp 285-289. 2) Wilson MM: Sexually transmitted diseases. Clin Geriatr Med 2003;19(3):637-655.
