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Hailey-Hailey disease associated with herpetic eczema-the value of the Tzanck smear test.

de Aquino Paulo Filho T, deFreitas YK, da Nóbrega MT, Lima CB, Carriço BL, Silva MA, Paulo FL, Neto PB - Dermatol Pract Concept (2014)

Bottom Line: The coexistence of those findings is a rare condition; only five cases have been published in literature.The man showed remission in the infection after 10 days under treatment with acyclovir.Research on the concomitance of infection by the herpes virus must be performed in the exacerbations of Hailey-Hailey disease, and, in those situations, the quick diagnosis through skin cytology makes the early treatment possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Medicine, Dermatology Center, Rio Grande do Norte University, Natal, Brazil.

ABSTRACT

Background: Herpetic eczema is a herpetic superinfection of a preexisting skin disease. Hailey-Hailey disease is an autosomal dominant dermatosis that is clinically characterized by flaccid vesicles and rashes in intertriginous areas. The coexistence of those findings is a rare condition; only five cases have been published in literature.

Purpose: To report the rare coexistence between Hailey-Hailey disease and herpetic eczema and to highlight the importance of cytology for a quick diagnosis.

Case report: A 38-year-old man had been diagnosed with Hailey-Hailey disease for 13 years. His condition evolved into what could be herpetic eczema, which was later confirmed by skin cytology and histopathology. The man showed remission in the infection after 10 days under treatment with acyclovir.

Conclusion: Research on the concomitance of infection by the herpes virus must be performed in the exacerbations of Hailey-Hailey disease, and, in those situations, the quick diagnosis through skin cytology makes the early treatment possible.

No MeSH data available.


Related in: MedlinePlus

Giant multinucleated cells and acantholytic cells in the same slide. Giemsa stain, at 400x. (Copyright: ©2014 Paulo Filho et al.)
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f2-dp0404a04: Giant multinucleated cells and acantholytic cells in the same slide. Giemsa stain, at 400x. (Copyright: ©2014 Paulo Filho et al.)

Mentions: A 38-year-old male single driver has been diagnosed with Hailey-Hailey disease, which has affected his axillary and inguinal regions for 13 years. Three months prior, he was being treated with acitretin 50 mg/day and desonide 0.05% alternating with tacrolimus 0.1% topically in the areas of exacerbation of lesions. A burning sensation, followed by redness, vesicles and subsequent ulcers in the inguinal region for about two days was reported. Physical examination showed vesiculopustules and areas with ulcerations in the inguinal region (Figure 1). Skin cytology showed giant viral multinucleated cells and characteristic changes of the underlying disease—acantholytic cells, not only parabasal ones, but also those from upper layers of the epidermis, giving them the aspect of “crumbling wall” (Figure 2). Histopathology confirmed the diagnosis of Hailey-Hailey disease and herpetic eczema (Figure 3). The treatment with acyclovir 400 mg three times daily for ten days was recommended with complete remission of the herpetic condition (Figure 4).


Hailey-Hailey disease associated with herpetic eczema-the value of the Tzanck smear test.

de Aquino Paulo Filho T, deFreitas YK, da Nóbrega MT, Lima CB, Carriço BL, Silva MA, Paulo FL, Neto PB - Dermatol Pract Concept (2014)

Giant multinucleated cells and acantholytic cells in the same slide. Giemsa stain, at 400x. (Copyright: ©2014 Paulo Filho et al.)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4230254&req=5

f2-dp0404a04: Giant multinucleated cells and acantholytic cells in the same slide. Giemsa stain, at 400x. (Copyright: ©2014 Paulo Filho et al.)
Mentions: A 38-year-old male single driver has been diagnosed with Hailey-Hailey disease, which has affected his axillary and inguinal regions for 13 years. Three months prior, he was being treated with acitretin 50 mg/day and desonide 0.05% alternating with tacrolimus 0.1% topically in the areas of exacerbation of lesions. A burning sensation, followed by redness, vesicles and subsequent ulcers in the inguinal region for about two days was reported. Physical examination showed vesiculopustules and areas with ulcerations in the inguinal region (Figure 1). Skin cytology showed giant viral multinucleated cells and characteristic changes of the underlying disease—acantholytic cells, not only parabasal ones, but also those from upper layers of the epidermis, giving them the aspect of “crumbling wall” (Figure 2). Histopathology confirmed the diagnosis of Hailey-Hailey disease and herpetic eczema (Figure 3). The treatment with acyclovir 400 mg three times daily for ten days was recommended with complete remission of the herpetic condition (Figure 4).

Bottom Line: The coexistence of those findings is a rare condition; only five cases have been published in literature.The man showed remission in the infection after 10 days under treatment with acyclovir.Research on the concomitance of infection by the herpes virus must be performed in the exacerbations of Hailey-Hailey disease, and, in those situations, the quick diagnosis through skin cytology makes the early treatment possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Medicine, Dermatology Center, Rio Grande do Norte University, Natal, Brazil.

ABSTRACT

Background: Herpetic eczema is a herpetic superinfection of a preexisting skin disease. Hailey-Hailey disease is an autosomal dominant dermatosis that is clinically characterized by flaccid vesicles and rashes in intertriginous areas. The coexistence of those findings is a rare condition; only five cases have been published in literature.

Purpose: To report the rare coexistence between Hailey-Hailey disease and herpetic eczema and to highlight the importance of cytology for a quick diagnosis.

Case report: A 38-year-old man had been diagnosed with Hailey-Hailey disease for 13 years. His condition evolved into what could be herpetic eczema, which was later confirmed by skin cytology and histopathology. The man showed remission in the infection after 10 days under treatment with acyclovir.

Conclusion: Research on the concomitance of infection by the herpes virus must be performed in the exacerbations of Hailey-Hailey disease, and, in those situations, the quick diagnosis through skin cytology makes the early treatment possible.

No MeSH data available.


Related in: MedlinePlus