Herpes simplex virus-induced plasmacytic atypia
Version of Record online: 12 NOV 2011
Copyright © 2011 John Wiley & Sons A/S
Journal of Cutaneous Pathology
Volume 39, Issue 2, pages 270–273, February 2012
How to Cite
Boyd, A. S., Zwerner, J. P. and Miller, J. L. (2012), Herpes simplex virus-induced plasmacytic atypia. Journal of Cutaneous Pathology, 39: 270–273. doi: 10.1111/j.1600-0560.2011.01817.x
- Issue online: 20 JAN 2012
- Version of Record online: 12 NOV 2011
- Accepted for publication July 5, 2011
- herpes simplex virus;
- immune compromise;
- pemphigus vulgaris;
- plasmacytic atypia
The clinical and histopathological features of cutaneous herpes simplex virus (HSV) infection have been well described. Genital herpetic infections are largely induced by HSV type 2, but 30% of cases can be caused by HSV type 1. Immunocompromised patients are known to exhibit atypical patterns of clinical presentation with variable lesion morphology and anatomic location. A subset of patients may show morphology such as nodules or verrucous lesions. Analogously, some biopsy specimens may show unusual microscopical features, such as a lack of keratinocyte cytopathology, lymphocyte infiltration or vasculopathic changes that are expected irrespective of the patient's immune status. We present the case of a patient carrying a previous diagnosis of pemphigus vulgaris, status posttreatment with methotrexate and prednisone, who developed a perineal ulcer exhibiting significant numbers of plasma cells, many of which were cytologically atypical. This morphology was suggestive of a hematopoietic malignancy. Immunoperoxidase staining for HSV decorated a focal collection of keratinocytes that lacked appreciable viral changes expected of HSV infection.
Boyd AS, Zwerner JP, Miller JL. Herpes simplex virus-induced plasmacytic atypia.