Disseminated mucocutaneous herpes simplex virus infection in an immunocompetent woman

Abstract

Disseminated mucocutaneous herpes simplex virus (HSV) infection in an immunocompetent person is quite rare. A 19-year-old healthy Japanese woman presented with painful, umbilicated vesicles and pustules on her genital region, both nipples and on the forearm 10 days after the last sexual contact with her partner who had cold sore at that time. Tzanck test and biopsy confirmed the diagnosis of disseminated mucocutaneous HSV infection. She did not have any visceral HSV disease. Skin lesions improved after treatment with acyclovir and erythromycin for seven days. We propose that like herpes gladiatorum, HSV dissemination in this case was acquired by close body contact.

Herpes Mastitis: Diagnosis and Management

“…Usually, lesions are restricted to areola. A few cases reaching the whole breast have been described . Sometimes, the clinical appearance may suggest an inflammatory breast carcinoma with Paget's disease of the nipple .…”

“…In nonlactating woman, infection can be acquired by autoinoculation . An extensive literature search located only two cases of herpes mastitis were undoubtedly due to sexual contact among which only one affected concomitantly the nipple and oral areas .…”

Reporting a case of peri-orificial herpes of the face due to HSV-1 recurrence: A new form?

“…This form is quite rare in immunocompetent individuals [2]. Hence, it was deemed necessary to investigate for immunosuppression in any patient with diffuse herpes infection.…”

Disseminated mucocutaneous herpes simplex in an atopic individual

“…2 Disease severity varies, but it is usually cutaneous and mild and will respond well to treatment with antiviral agents such as aciclovir and valaciclovir. 3 However, dissemination with visceral involvement can occur, causing complications such as a necrotizing encephalitis, hepatitis and mortality. 1 Disseminated mucocutaneous herpes simplex has also been reported widely in individuals with impaired immunity such as pregnancy (especially third trimester), corticosteroid therapy and other immunosuppressive drug use, haemapoietic disorders, bone marrow and solid organ transplants, neonates, 3 cancer patients and burn victims.…”

“…3 However, dissemination with visceral involvement can occur, causing complications such as a necrotizing encephalitis, hepatitis and mortality. 1 Disseminated mucocutaneous herpes simplex has also been reported widely in individuals with impaired immunity such as pregnancy (especially third trimester), corticosteroid therapy and other immunosuppressive drug use, haemapoietic disorders, bone marrow and solid organ transplants, neonates, 3 cancer patients and burn victims. 4 Acute ocular involvement beyond a blepharitis is uncommon 5 but herpetic keratitis has been reported.…”