PMC9035401_01
Well-demarcated, purulent vegetative plaques with central brown/black eschar and surrounding erythema, 1-2 cm in diameter, located on the right posterior shoulder.
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Dermatology was consulted for the evaluation of two painless well-demarcated, purulent vegetative plaques with central brown/black eschar and surrounding erythema, 1-2 cm in diameter, located on the right posterior (Fig. 1).
Punch biopsy obtained from the periphery of the lesion shows epithelial hyperplasia, ulceration, eosinophilic intranuclear inclusions, and multinucleated keratinocytes surrounded by a dense inflammatory infiltrate, typical of herpes simplex virus. (H&E); Original magnifications: A, x40; B, x200.
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A punch biopsy was performed and showed epithelial hyperplasia, ulceration, eosinophilic intranuclear inclusions and focal multinucleated keratinocytes surrounded by a dense inflammatory infiltrate (Fig. 2A and B) with no evidence of malignancy.
Immunohistochemical analysis demonstrates strong positivity of a polyclonal antibody against herpes simplex virus 1 and 2. Immunoperoxidase stain; Original magnification: x200.
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Immunoperoxidase stain was strongly positive for HSV 1 and 2 (Fig. 3).