Viral folliculitis. Atypical presentations of herpes simplex, herpes zoster, and molluscum contagiosum

Fulminant Herpetic Sycosis: Atypical Presentation of Primary Herpetic Infection

“…Our case of herpetic sycosis is unusual owing to its occurrence in primary herpetic infection in a healthy patient with no argument for latent immunosuppression. The onset of fulminant herpetic folliculitis from the initial lesion on the nasogenial fold can be explained by propagation of the viral particles by shaving of the beard [4,5]. The absence of pre-existing immunity against HSV-1 in our patient may explain the strong local and systemic inflammatory reaction.…”

“…An eczema herpeticum must also be excluded in the case of an atopic patient, but there is often dissemination of lesions outside the beard area. In immunocompromised patients, it is also 286 Dermatology 2004;208:284-286 Campanelli/Marazza/Stucki/Abraham/ Prins/Kaya/Piguet/Saurat necessary to consider folliculitis due to molluscum contagiosum [3,4,6,7]. In conclusion, in the presence of inflammatory papulovesicular beard lesions, it is necessary to take into account a broad range of differential diagnoses.…”

Herpetic Folliculitis

“…He shared many of the clinical features of the two cases of Izumi et al 2 and of the first two cases reported by Weinberg et al 6 The patients were healthy males, their beard area was involved, they failed antibiotic treatment, they had rapid spread of the lesions, and they had no systemic symptoms. Our case showed what seems to be much more extensive involvement of the beard area and a more striking follicular distribution.…”

“…In Weinberg et al 6 cases 3 and 4 and the 2 cases of Sexton, 4 the viral cytopathic effects were limited to the follicular epithelium and spared the surrounding epithelium, thus explaining the atypical clinical findings in these cases.…”

“…Weinberg et al 6 described 5 patients with a variety of viral folliculitides, 4 of which were herpetic and 1 was caused by molluscum contagiosum. The 4 herpetic folliculitides were as follows: 2 with herpetic sycosis, 1 with herpes simplex folliculitis (this patient also had HIV), and 1 with herpes zoster without blisters.…”