title: Fulminant herpetic sycosis: atypical presentation of primary herpetic infection.
abstract: 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.
authors.affiliation: Department of Dermatology, Geneva University Hospital, Geneva, Switzerland. alexandre.campanelli@hcuge.ch
authors.forename: A
authors.initials: A
authors.lastname: Campanelli
authors.forename: G
authors.initials: G
authors.lastname: Marazza
authors.forename: L
authors.initials: L
authors.lastname: Stucki
authors.forename: S
authors.initials: S
authors.lastname: Abraham
authors.forename: C
authors.initials: C
authors.lastname: Prins
authors.forename: G
authors.initials: G
authors.lastname: Kaya
authors.forename: V
authors.initials: V
authors.lastname: Piguet
authors.forename: J-H
authors.initials: JH
authors.lastname: Saurat
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir