Aku Tak Butuh Cinta

“Cuuy gw balik dulu yaaah”ucap gw ketemen temen gw yang lagi pada nongkrong di depan kampus,waktu menunjukan pukul empat sore,mata kuliah bahasa inggris udah bener bener bikin perut gw yang kroncongan tambah melilit,akhirnya gw putsin usai kuliah gw mau langsung ke kostan temen gw,karna gw pikir semoga dikostannya ada sesuatu yang bisa mengganjal perut gw yang kroncong protol,yang cuma baru di isi dua buah kueh pancong tadi pagi,hari ini gw bener bener boke,miskin,pakir,kere,ntah apa lagi istilah lain yang lebih daramatis,yang hanya bermodalkan duit gopean yang nyelip di kantong celana yang kemudian gw beliin kueh pancong yang terletak disamping kampus sewaktu gw mau berangkat kuliah,setelah itu ta ada lagi Sesutu yang masuk ke dalam perut gw,mungkin untuk saat ini gw adalah seseorang yang berhak mendapatkan pundi amal SCTV,karna emang gw bener bener ga megang duit sama sekali,bahkan pengemispun jauh lebih kaya ketimbang gw,makanya setelah pulang kuliah gw lebih memilih balik ketimbang nongkrong nongkrong yang paling Cuma di sodori rorko doang yang sama sekali ga bisa membuat perut gw merasa sedikit bahagia,di sepanjang perjalanan menuju kostan temen gw,gw Cuma bisa tertunduk simpul menahan perasaan melihat serentetan pedagang pecel lele,seefood,surabimod,dan gorengan yang terjejer manis di kawasan panorama yang terletak di kota bandung,godaan dan rintanganpun gw hadepin sampai akhirnya gwpun sampai juga di kostan temen gw,rasa bahagia,sedih,,harupun bercampur aduk dalam perasaan gw saat ini,sekalipum gw belum mendapatkan apa apa,setidaknya gw merasa bahagia telah berada tepat di depan pintu kostan temen gw,tak sabar rasanya untuk masuk dan menikmati makanan makanan yang terjejer manis di dapur,dengan antusias gw pun mengetuk pintu kostannya,
“hallo,,smlikum”ucap gw sambil mengetuk pintu kostannya,taklama kemudian muncul seseorang di balik pintu “eeh lo nang,,”ucapnya kaget ngeliat gw “ayo masuk”printahnya.
“giman kabar lo deen”Tanya gw sambil masuk kamarnya dan duduk di depan televisi..
“maksud loo…?”
“ngga,, kabar lo sehat ga?”Tanya gw lagi sembari mengambil remot yang ada di depan gw
“sehat.!!”ucapnya santai
Gw bingung harus ngomong apa lagi,sesaat kami terdiam,gw hanya bisa ngutak ngatik remot TV yang membuat ga jelas acaranya,akhirnya sidenipun kesal ngeliat gw yang ga jelas mau nonton apa,
“nyari apaan siih lo nang?”ucapnya kesel
“ga tau niiih acaranya ga ada yang bagus” jawab gw tanpa menoleh ke arahya.
“ohya,,ngomong ngomong kebeneran nih lo kesini”
Akhirnya tanda tanda dia akan nawarin makanan pun sudah terdengar jelas di telinga
“yaiyalaaah,,gw kan punya radar”ucap gw cengengesan “sinyal kuat indosat” ucap gw lagi
Si deni malah geleng geleng kepala “gila emeng temen gw yang satu ini tau aja kalo gw lagi butuh pertolongan”
Gw terdiam sejenak,ntah apa maksud dari omonganya itu,kalo dia sekarang lagi butuh pertolongan,Aaah paling paling itu Cuma masalah nganter dia kewarnet,ucap gw dalam hati
“maksud lo den?lo minta gw nganter lo ke warnet lagi,,,!!”
“bukan itu maksud gw nang,,”kali ini dengan tempang melas
“Oooh masalah yang itu!!”ucap gw so yakin
Kali ini ia sedikit tersenyum mendengar ucapan gw “ iya nang masalah itu,,lo paham kan?”
“he,,he,,tenang aja msalah itu mah,nanti gw bakal bilang sama si rini kalo lo cowo baik baik,,bukan gay dan tida homo..”
Tampangnya kini memelas lagi “bukan itu maksud gw nang,,!!”
Sebuah pertanyaaan yang telah membut gw ternganga “laah terus masalah apa dong??”
“gini nang”desahnya “dari tadi pagi gw belum makan apa apa tau,,!gw mau beli makan ga ada duit mau masak di dapur ga da yang bisa di masak sama sekali,,makanya kebeneran lo kesini,,gw mau minjem duit sama lo nang..!!!ada ga??”
Sebuah ungkapan yang telah membuat gw tersipu,gw hanya terdiam mendengar keluhanya yang ternyata lebih parah ketimbang gw,akhirnya gw jadi lebih sadar ternyata di bawah langit ada langit lagi,
“untuk masalah ini gw ga bisa bantu lo den”ucap gw tega
“jadi lo ga mau minjemin gw niih..?”tanyanya dengan mimik super melas,gw jadi tambah ga tega ngeliatnya,namun apalah daya diri ini tak bisa berbuat apa apa.
“bukanya gitu cuuy,,”ucap gw sembari menepuk pundaknya, “untuk masalah ini kita senasib,,gw kesini sebenarnya tida lain dan tida bukan mau numpang makan sama lo,,yang tadinya gw pikir kali aja lo ada makanan yang bisa gw makan,,nyatanya kita senasib den,,sama den gw juga belum makan apa apa dari pagi Cuma dua buah kueh pancong yang baru masuk kedalam perut gw,,”
Sideni juga melongo mendengar pernyataan gw yang juga menyedihkan
“trus gimana doong,,??”tanyanya
“yaudahlah den,,klo gitu gw mau balik aja,,gw mau tidur”ucap gw yang kemudian berdiri dan berbalik menuju pintu
“yaudah deh,,kalo gitu gw juga mau tidur”
“oke den,,gw cabut yaah”ucap gw setelah beres memakai sepatu
“hati hati yaa,,moga kita mimpi makan besar nang,,,nanti awas jangan pelit lo yaah”
“siap”ucap gw sambil meninggalkan kostannya.
Heeh,,tenyata bayangan makanan itu hanya ada dalam negri dongeng,beginilah keadaan anak kost yang belum dapet kiriman,hanya bisa berharap bisa bermimpi indah.setelah itu gw pun pulang ketempat di mana gw tinggal,sebuah kamar kost yang gw harap mengeluarkan keajaiban berubah menjadi sebuah mall besar atau seengganya alfamart,atau kalo ga warung juga ga apa apa,,,namun itu tadi !!
itu hanyalah sebuah hayalan tingkat tinggi,tak ada yang berubah dari kostan gw,setibanya gw di kostan waktu menunjukan pukul enam sore,kayanya kurang lazim kalo gw harus tidur magrib magrib kaya gini,kemudian gw pun menengok ke kostan temen gw yang berada tepat di samping kostan gw,boris namanya,mahsiswa asal medan yang merantau ke bandung untuk mencari kebahagiaan untuk masa depan katanya,untuk saat ini gw butuh pertolonganya,gw perhatikan kostanya pintunya terbuka lebar,gw lihat dia tengah asik tidur tiduran sembari melihat TV,gw pun berjalan menghampirinya
“eeh kou,,nang”ucapnya kaget yang ternyata sedang menonton bokep,lalu aku duduk di sampingnya
“nang,,kou sudah makan belum?”pertanyaan itu membuatku tersenyum “aku belum makan ris,,”
Ia malah tersenyum mendengar kata kata gw barusan, “kalo gitu kita sama nang,,kau mau makan tak??”ucap siboris sembari memukul paha gw
“ya mau laah”jawab gw antusias
“kalo gitu,,aku..teraktir yaah nang?”ucapnya antusias pula
Gw tersenyum mendengarnya“waah yang bener lo,,boleh boleh”
“tapi aku mau salat magrib dulu yaah nang,,”
“Oke siap,,berarti abis magrib kita makan niiih”
“yaudah mending kamu salat magrib dulu sanah”ucapnya sembari mengusir gw dari kostannya.
Akhirnya keajaiban datang juga,cacing cacing yang ada dalam perut gw langsung pada cengengesan mendengar kalo abis magrib gw akan makan.
Lima menit telah berlalu dimana gw juga udah kelar melaksankan salat magrib,siboris yang katanya mau nraktir gw itu pun udah manggil manggil di depan kamar gw
“Naang,,anang,,ayolah kita jalaan aku sudah lapar kali niiih”
“iya,,iya sabar”ucap gw sembari membuka pintu kostan
“kau mau makan apa nang?”ucapnya santai,gw hanya terdiam sesaat Gila niih temen gw yang satu ini bener bener pengertian sampai sampai nawarin gw mau makan apa segala,batin gw!
“gw maah ga mau muluk muluk ris,,gw cukup pengen makan mie kocok aja,,emang lo mau makan apa?”
“yaah aku terserah kau,,?”
Gw sedikit bingung mendengarnya“yaudah terserah lo aja deeh,,yang penting gw makan”
Lalu kami pun turun dan berangkat menuju warung terdekat,sesampainya di warung siborispun dengan penuh antusias memanggil manggil si pemilik warung
“halloo spada,,!!bang,,aku mau beli niih”ucapnya untuk ketiga kalinya
Kemudian muncul si pemilik warung “yaah beli apa yaah de,,?”
“aku amu beli miee kocok dua bang,,buat aku satu buat temen aku satu”
Si pemilik warung itupun mencarinya kemudian balik lagi dengan membawa satu buah mie kocok
“waah de,,mie kocoknya tinggal satu!!”
Si boris pun berbalik ke arah gw dan meminta persetujuan gw, “yaah terserah loo,,tapi mending nyari warung lain aja laah!!”karna mengutamaka kebersamaan gw pun menyuruhnya untuk membatalakannya,
“waah kayanya aku tak jadi beli bang soalnya kata temen aku ta usahlah kalo Cuma ada satu”
Dengan sedikit perasaan kecewa kamipun meninggalkan warung itu, segera kami pun menuju ke warung berikutnya namun apalah daya sial lagi lagi tak bisa di hadang,sesampainya disana ternyata warung itu tutup,boris pun berinisiatip untuk balik lagi kewarung sebelumya dan mengalah untuk tida harus dapat yang mie kocok
“sudah laah nang aku cape,,lebih baik kou beli mie yang disana saja laah,,ta apalah bukan aku yang mie kocok”ucapnya melirik kerah warung yang pertama
“yaudaah kalo gitu,,biar gw aja yang beli,,sini uangnnya”ucap gw sambil menyodorkan tangan
Boris malah kaget “loooh ko minta duit sama aku”
“laah katanya lo yang mau neraktir gw”
“yaah aku sudah bilang sama kou ,,aku ,,”menujuk kearah dirinya “teraktir yaah”lanjutnya lagi
Aku tersenyum lemes mendengarnya “kirain gw lo yang mau neraktir gw”
“berarti tadi,,”ucap kami serentak,celingukan sambil menunjuk kearah warung itu.
Dan kami pun tertawa terbahak bahak,sambil bergantian menjendulkan kepala,
“untung ajaa mie kocoknya ga ada,,coba kalo ada,di Tanya duit,celingukan kita!!”ucap gw sambil tertawa
Akhirnya kami pun kembali ke kostan dengan tangan kosong,perut memeng melilit namun meski begitu gw seneng bisa merasakan ternyata perbedaan itu indah,si boris yang bermaksud begini ternyata gw anggap begitu.tapi buat gw sekarang yang penting hati senang walau pun tak punya uang. iya ga?

Sebagian Polewali Terserang Wabah Diare

Liputan6.com, Polewali: Pemerintah Polewali Mandar, Sulawesi Barat, menetapkan sejumlah kecamatan masuk kategori kejadian luar biasa (KLB) diare. Sebab, hanya dalam sepekan, sekitar 300 anak dilarikan ke petugas kesehatan. Bahkan, enam di antaranya meninggal dunia sebelum mendapat penanganan medis.

Berdasarkan pantauan SCTV, Ahad (7/6), faktor kemiskinan dan jauhnya akses pelayanan kesehatan dari permukiman warga diduga menjadi penyebab satu keluarga terserang diare akut. Seorang anaknya meninggal dunia, sedangkan satu lainnya dilarikan ke rumah sakit setelah kakaknya dikebumikan.

Kepala Bidang Pengendalian Masalah Penyakit Dinas Kesehatan Polewali Mandar, Hartini Asis mengatakan, selain menggelar penyuluhan kesehatan di sejumlah lokasi yang terjangkit, Dinkes juga telah mengirim bantuan obat-obatan seperti oralit dan cairan infus. Langkah ini ditempuh demi mengantisipasi jatuhnya korban baru.

Meski demikian, jika kecenderungan diare terus meningkat hingga beberapa hari mendatang, Dinkes akan melakukan uji sampel kotoran korban diare. Terutama, untuk memastikan jenis bakteri yang menyerang warga.(UPI)

Herpes Zoster dan lain2

Herpes Zoster

Laboratory Studies

• Diagnosis of herpes zoster is based primarily on clinical findings, specifically the characteristic location and appearance of the skin eruption in association with localized pain. However, in some patients, the presentation of herpes zoster can be atypical and may require additional testing. This is particularly true in immunocompromised patients.
• Varicella-zoster virus can be cultured successfully; this has limited use in the ED due to the long time required for viral growth.
• If necessary, a definitive diagnosis can be confirmed by sending swabs to the laboratory.
• Lift the top of the lesion and swab the exposed base. The swab should then be rolled across a sterile glass side, which is air dried and sent to the laboratory for staining with immunofluorescent antibodies.
• The swab can also be placed in viral transport medium for detection of viral DNA by polymerase chain reaction.
• Tzanck smear can be obtained from the vesicular lesions; however, the smear does not differentiate between varicella-zoster virus and other herpes virus infections such as herpes simplex.
• A Tzanck smear is a simple test that may be performed by the clinician or in a laboratory.
• A fresh blister is unroofed and material from the base is smeared on a slide.
• Wright stain is applied, and the smear is examined under the microscope.
• A positive result shows distinctive giant cells with multiple nuclei.
• This test has a significant false-negative rate of at least 20%. Therefore, a negative result does not rule out a herpes virus infection and should not preclude empiric treatment.
• Empiric treatment, when indicated, should not be delayed pending the results of diagnostic tests.

Imaging Studies

No imaging tests are indicated in typical cases of cutaneous VZ infection.

Other Tests

• Monoclonal antibody tests
• Blood mononuclear cell testing for viral DNA (research)

Procedures

• Biopsy for direct immunofluorescence testing (rarely performed)

Treatment

Symptomatic treatment

• Patients with herpes zoster usually experience pain. Antiviral and steroid therapy provides relatively minor relief of pain, and analgesics are often needed.
• Initial therapy may include nonsteroidal anti-inflammatory drugs (NSAIDs).
• In many cases, narcotic analgesia is necessary.
• A randomized clinical trial of oral analgesics for acute pain in patients with herpes zoster was conducted (n-87; age 50 years or older). Treatment was begun within 6 days of rash onset and with worst pain within 24 hours. Patients were initiated on a 7-day course of famciclovir with controlled-release (CR) oxycodone, gabapentin, or placebo for 28 days. Discontinuing participation, primarily associated with constipation, occurred most frequently in patients randomized to CR-oxycodone (27.6%) compared with placebo (6.9%). Mean worst pain was reduced the first week with CR-oxycodone compared with placebo (p=0.01). Gabapentin did not provide significantly greater pain relief than placebo, although the first week provided a modest reduction of pain.²
• A randomized, double-blind, placebo-controlled study of extended-release gabapentin (gabapentin ER) demonstrated improvement in average daily pain score in patients with acute herpes zoster. In those taking gabapentin, a reduction of pain of 50% or greater from baseline was reported by 25.5-28.8% compared with 11.8% of patients taking placebo.³
• Wet to dry dressings with tap water or 5% aluminum acetate (Burow solution). Apply to the affected skin for 30-60 minutes 4-6 times per day.
• Bland lotions (ie, Calamine) may help relieve discomfort.

Antiviral therapy for uncomplicated herpes zoster

The goals of antiviral therapy are to decrease pain, to promote healing of skin lesions, and to prevent or reduce the severity of postherpetic neuralgia. Acyclovir and the newer antivirals valacyclovir and famciclovir have been shown to be effective if given within 48-72 hours of the appearance of the rash. The newer agents have better bioavailability and do not need to be given as frequently. Outcomes studied have included time to crusting of skin lesions, duration and severity of acute pain, and duration and incidence of postherpetic neuralgia.

Acyclovir has been the most studied and widely recommended, but in a blinded, randomized comparison trial, valacyclovir was shown to be superior to acyclovir.^5,6 The trial included more than 1100 patients with uncomplicated zoster who were 50 years or older. Adverse effects were similar in both groups. Outcomes evaluated included resolution of acute pain and the duration of postherpetic neuralgia.

The duration of antiviral treatment in studies has varied from 7-21 days. Based on current literature, for immunocompetent patients, acyclovir for 7-10 days or a 7-day course of the newer agents is appropriate. Longer courses may be needed in immunocompromised patients.

Combined antiviral and corticosteroid therapy for uncomplicated herpes zoster

The addition of corticosteroids has been evaluated in patients treated with acyclovir. The benefit of steroids included accelerated healing of lesions and more rapid resolution of acute pain.⁷ Though statistically significant, the benefits were small. There was no effect on the development or duration of postherpetic neuralgia.

Steroids have not been studied with valacyclovir of famciclovir, so the benefit is unknown. The addition of steroids should be considered only in patients with severe symptoms. Steroids should not be given alone (without antiviral therapy) due to concern about promotion of viral replication. The effect of steroids on the incidence of secondary skin infection is unknown. Some authors have suggested that they may increase the risk. Prednisone, 40-60 mg/day, is a reasonable choice if steroids are used. The optimal duration of steroid therapy is not known. If prescribed, it seems reasonable for steroids to be used concurrently with antiviral therapy. The duration of steroid use should not extend beyond the period of antiviral therapy.

Treatment of complicated herpes zoster

Patients who are immunosuppressed are at risk for extensive skin involvement or disseminated disease. Although strong evidence is lacking, the following are highlights of some of the current recommendations for treating zoster in these patients.

• Treat all immunosuppressed patients with antivirals, even when the onset of symptoms is more than 72 hours.
• Valacyclovir should be used if oral therapy is selected.
• Consider treatment with intravenous acyclovir for the following patients:
• Transplant patients soon after transplantation or when being treated for rejection
• Patients with advanced HIV
• Patients with widespread skin involvement or visceral disease

Treatment of herpes zoster ophthalmicus

Two trials comparing oral acyclovir to famciclovir or valacyclovir in patients with ophthalmic zoster showed comparable outcomes with any of the regimens. Patients with diagnosed or suspected ophthalmic zoster should receive antivirals and be referred to an ophthalmologist.

Post exposure prophylaxis

Varicella-zoster immune globulin (VZIG) prevents or modifies clinical illness in susceptible, persons who are exposed to varicella or zoster. It should be reserved for patients at risk for complications such as those who are immunocompromised, pregnant, and for neonates.

Risk Factors for Chickenpox (Varicella)

Between 75 - 90% of chickenpox cases occur in children under 10 years of age. Before the introduction of the vaccine, about 4 million cases of chickenpox were reported in the U.S. each year. Since a varicella vaccine became available in the U.S. in 1995, however, the incidence of disease and hospitalizations due to chickenpox has declined by nearly 90%.

The disease usually occurs in late winter and early spring months. It can also be transmitted from direct contact with the open sores. (Clothing, bedding, and such objects do not usually spread the disease.)

A patient with chickenpox can transmit the disease from about 2 days before the appearance of the spots until the end of the blister stage. This period lasts about 5 - 7 days. Once dry scabs form, the disease is unlikely to spread.

Most schools allow children with chickenpox back 10 days after onset. Some require children to stay home until the skin has completely cleared, although this is not necessary to prevent transmission.

Risk Factors for Shingles (Herpes Zoster)

About 500,000 cases of shingles occur each year in the U.S. Anyone who has had chickenpox has risk for shingles later in life, which means that 90% of adults in the U.S. are at risk for shingles. Shingles occurs, however, in 10 - 20% of these adult over the course of their lives, so certain factors must exist to increase the risk for such outbreaks.

The Aging Process. The risk for herpes zoster increases as people age, and the overall number of cases will undoubtedly increase as the baby boomer generation gets older. One study estimated that a person who reaches age 85 has a 50% chance of having herpes zoster. The risk for postherpetic neuralgia (PHN) is also highest in older people with the infection and increases dramatically after age 50. PHN is persistent pain and is the most feared complication of shingles.

Immunosuppression. People whose immune systems are impaired from diseases such as AIDS or childhood cancer have a risk for herpes zoster that is much higher than those with healthy immune systems. Herpes zoster in people who are HIV-positive may be a sign of full-blown AIDS. Certain drugs used for HIV, called protease inhibitors, may also increase the risk for herpes zoster.

Cancer. Cancer places people at risk for herpes zoster. At highest risk are those with Hodgkin's disease (13 - 15% of these patients develop shingles). About 7 - 9% of patients with lymphomas, and between 1 - 3% of patients with other cancers, have herpes zoster. Chemotherapy itself increases the risk for herpes zoster.

Immunosuppressant Drugs. Patients who take certain drugs that suppress the immune system are at risk for shingles (as well as other infections). They include:

• Azathioprine (Imuran)
• Chlorambucil (Leukeran)
• Cyclophosphamide (Cytoxan)
• Cyclosporine (Sandimmune, Neoral)
• Cladribine (Leustatin)

These drugs are used for patients who have undergone organ transplantation and are also used for severe autoimmune diseases caused by the inflammatory process. Such disorders include rheumatoid arthritis, systemic lupus erythematosus, diabetes, multiple sclerosis, Crohn's disease, and ulcerative colitis.

Lack of Exposure to Children Infected with Chickenpox. Interestingly, one study suggested that previously infected adults who are exposed to children with chickenpox may receive an extra boost in antibody production, which can actually help them fight off herpes zoster. This means that as more children are vaccinated against chickenpox, more adults may be at risk for herpes zoster.

Risk Factors for Shingles in Children. Although most common in adults, shingles occasionally develops in children. One study reported that only 5% of cases occur in those under age 15. Children with immune deficiencies are at highest risk. Children with no immune problems but who had chickenpox before they were 1 year old also have a higher risk for shingles.

Deterrence/Prevention

• Theoretically, current varicella vaccines will reduce zoster incidence.
• Vaccines are being tested for prevention of herpes zoster in individuals previously infected with wild varicella-zoster virus.
• Patients with zoster may transmit the virus, causing infections in susceptible persons (who have not had prior infection).
• Discharge instructions should include patient education to avoid contact with susceptible individuals, especially if they are pregnant (due to concerns about congenital varicella) or immunocompromised.
• Transmission is by direct contact, and lesions are considered infectious until they are all crusted over.

Complications

Complications of herpes zoster may include the following:

• Postherpetic neuralgia
• Ocular involvement with facial zoster
• Meningoencephalitis
• Cutaneous dissemination
• Superinfection of skin lesions
• Hepatitis/pneumonitis
• Peripheral motor weakness/segmental myelitis
• Cranial nerve syndromes, particularly ophthalmic and facial (Ramsay Hunt syndrome)
• Corneal ulceration
• Guillain-Barré syndrome

Prognosis

• Rash usually resolves within 14-21 days.
• Postherpetic neuralgia is defined as pain persisting at least 1 month after the rash has healed. Its incidence increases dramatically with age (ie, 4% in those aged 30-50 years, 50% in those older than 80 years).

Shingles ( Herpes Zoster ) Stages

There are two stages of shingles:

1.The prodromal stage - at this stage symptoms occur about 2 to 5 days before the rash appears.

2.The eruptive stage - at this stage of shingles skin rash (lesions) appears.

How is impetigo diagnosed?

Diagnosing impetigo is mostly straightforward, though occasionally other conditions may look something like it, such as tinea (fungus, "ringworm") or scabies (mites). It is important to note that not every blister or ooze means infection. At times, other infected and noninfected skin diseases produce blister-like skin inflammation. Such conditions include herpes cold sores, chickenpox, poison ivy, other skin allergies, eczema, and insect bites. Secondary infection of these diseases does occur sometimes, but often blistering comes from the original condition and does not mean that actual impetigo has developed. Medical judgment -- helped by culture tests, when necessary -- is needed to decide whether antibacterial creams or pills should be used in addition to the remedies suitable for the original condition.

Diagnosis of Herpes Simplex

The herpes simplex virus is usually identifiable by its characteristic lesion: A thin-walled blister on an inflamed base of skin. However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone. In addition, some patients who carry the virus may not have visible genital lesions. Laboratory tests are essential for confirming herpes diagnosis. These tests include virologic tests (which examine samples of skin taken from the lesion) and serologic tests (blood tests that detect antibodies).

In its 2006 guidelines for sexually transmitted diseases, the U.S. Centers for Disease Control (CDC) recommends that both virologic and serologic tests be used for diagnosing genital herpes. Patients diagnosed with genital herpes should also be tested for other sexually transmitted diseases.

According to the CDC, up to 50% of first-episode cases of genital herpes are now caused by herpes simplex virus 1 (HSV-1). However, recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than herpes simplex virus 2 (HSV-2). It is important for doctors to determine whether the genital herpes infection is caused by HSV-1 or HSV-2, as the type of herpes infection influences prognosis and treatment recommendations.

How is Contact Dermatitis Diagnosed?

The diagnosis of contact dermatitis should be considered when a person has any acute or chronic rash that typically itches, but may also sting or burn. The rash classically has small blisters containing clear fluid, but can swell, crust, ooze or peel in other cases.

The diagnosis is made with a patch test, which involves the placement of various chemicals on the back for approximately 48 hours (it is not the same as allergy testing). This typically is done with a paper tape system, such as the TRUE test. The TRUE test is the only FDA approved test for contact dermatitis in the United States, although some allergists and dermatologists will develop more extensive patch test panels with chemicals purchased from Canada or Europe.

The results of the test are interpreted at 48 hours after placement, and again at 72 or 96 hours after placement. A positive test is confirmed when there are blisters, redness, and mild swelling at the site of the particular chemical in question. The site of the positive test usually itches, although the reaction size is typically limited to the site of contact, and therefore is usually smaller than a dime.