Fulminant herpetic sycosis: atypical presentation of primary herpetic infection.
Fulminant herpetic sycosis is a rare but well-known manifestation of herpes simplex virus (HSV) infection occurring in the context of viral recurrence in immunodepressed patients. We present here the case of a 32-year-old male patient, without notable medical history, who developed papulovesicular lesions of the beard accompanied by fever, painful cervical lymphadenopathy and odynophagia, with a clinical evolution that was initially unfavourable under antibiotic treatment. The diagnosis of herpetic sycosis was established by means of direct immunofluorescence and culture which confirmed positivity for HSV-1 and serologies compatible with a primary viral infection. No sign for a latent immune deficit was found at the time of investigations. The clinical evolution was rapidly favourable with administration of intravenous aciclovir for 1 week. To our knowledge, herpetic sycosis as a presentation of primary viral infection has not been reported previously. The possibility of a herpetic sycosis of the beard must be considered in the case of non-response to antibiotic or antifungal treatment.
Campanelli
A
A
Department of Dermatology, Geneva University Hospital, Geneva, Switzerland. alexandre.campanelli@hcuge.ch
Marazza
G
G
Stucki
L
L
Abraham
S
S
Prins
C
C
Kaya
G
G
Piguet
V
V
Saurat
J-H
JH
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005148:Facial Dermatoses / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D005499:Folliculitis / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D006561:Herpes Simplex / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male
D000998:Antiviral Agents; D000212:Acyclovir