A 28-year-old man presented with recurrent outbreaks of herpes simplex virus (HSV) type 2 in the form of ulcers on the glans penis associated with the onset of red-to-brown maculopapules located predominantly in trunk in each recurrence. The patient had four recurrences on a two-year followup (Figure 1(a)).
Positive serologies to HSV type 2 were detected in each outbreak (IgM and IgG). He received acyclovir 400 mg five times a day for 5 days, then a prophylactic dose of 400 mg twice a day; however, after discontinuation of antiviral drug, lesions reappeared.
Histopathological examination of one of the lesions showed epidermal acanthosis, scanty lymphocytic exocytosis, without spongiosis, or focal necrosis. Perivascular infiltrates of lymphocytes with occasional eosinophils and erythrocytic extravasation were seen in the dermis (Figure 1(b)). HSV DNA was not detected in the epidermal keratinocytes or lymphocytes in the biopsy specimen. These findings were consistent with a diagnosis of pityriasis lichenoides chronica.