Case 39

M55. 15yr H/O eczematous eruption neck, axillae and groins.

• A Hailey - Hailey disease with pseudoherpetic features

• B Herpesvirus infection

• C Hailey - Hailey disease with coexistent herpesvirus infection

• D Galli-Galli disease

HSV II

Primary acantholytic disorders and herpesvirus infection: clinical issues

• Herpesvirus infection coexisting at sites affected by a primary acantholyticdisorder (i.e. HHD): results in localized disease flare without widespread dissemination.

• Widespread primary or recurrent herpesvirus infection with systemic upset complicating a primary acantholytic disorder (Darier>Grover>>HHD): dermatological emergency (Kaposi’s varicelliform eruption)!

Case 39

• A Hailey - Hailey disease with pseudoherpetic features

• B Herpesvirus infection

• C Hailey - Hailey disease with coexistent herpesvirus infection

• D Galli-Galli disease

Primary acantholytic disorders and herpesvirus like changes: histopathological issues

Pseudoherpetic changes (in Grover’s disease)

Pseudoherpetic changes (in Grover’s disease)

Am J Dermatopathol. 2014; 36: 746-750.

HHD and herpesvirus infection: learning points

• Primary acantholytic disorders are classified on the basis of: location and extent of acantholysis, presence or absence of dyskeratosis, nature of the dermal inflammatory infiltrate and IF findings.

• Coexistance of a primary acantholytic disorder and herpesvirus infection may potentially herald a life threatening condition (KVE).

• Cytologically, acantholytic cells of a primary acantholytic disorder may be confused with herpesvirus infected cells (pseudoherpetic changes).