Extensive cutaneous involvement due to herpes simplex virus infection.

Vilaça A, Pimentel T. BMJ Case Rep 2017. doi:10.1136/bcr-2017-221003 Description A 39-year-old woman, with a medical history of oligofrenia, obesity and varicella at 8 years of age, presented to the emergency department (ED) with multiple skin lesions of upper limb, which began with the appearance of vesicles, associated with intense pain and pruritus and with 3 days of evolution. No fever was reported. She was discharged home medicated with acyclovir and hydroxyzine. Three days later, she returned to the ED with worsening complaints of pain and itching, and extension of cutaneous lesions throughout the body. On physical examination, she was febrile (T: 38.5°C), with erythematous-pruriginous lesions, some of which were typically targeted, associated with numerous bullae dispersed throughout the body with oral mucosa involvement (figure 1A–C). Laboratory investigation revealed normal complete blood count. Serology tests confirmed that the patient was positive for herpes simplex virus (HSV) and there was threefold rise in antibody titre. Serology for other infectious agents, microbiology and autoimmune blood work studies were negative. At this point, extensive cutaneous involvement due to HSV infection was assumed as a diagnosis. Extensive cutaneous involvement due to herpes simplex virus infection Ana Vilaça, Teresa Pimentel Images in...