PMC5093277_01
Psoriasis herpeticum. Erythematous scaly plaques with peripheral hyperpigmentation involving the (a) face, scalp, (b-d) torso, and extremities, with scattered ~1 cm erosions.
CRIOG2016-5319425.001.jpg
PMC5093277_01_CRIOG2016-5319425.001.jpg
fig1
Cutaneous examination revealed erythematous scaly plaques with peripheral hyperpigmentation involving the scalp, face, arms, abdomen including the umbilicus, and pretibial legs, with scattered ~1 cm erosions within the plaques (Figure 1).
Psoriasis herpeticum. Punch biopsy specimen of the left leg demonstrating (a) psoriasiform acanthosis, epidermal necrosis, and acantholysis with (b) multinucleate keratinocytes with margination of chromatin and nuclear molding (hematoxylin-eosin stain; original magnification: (a) x40; (b) x400).
CRIOG2016-5319425.002.jpg
PMC5093277_01_CRIOG2016-5319425.002.jpg
fig2
Punch biopsy of a representative skin lesion revealed psoriasiform acanthosis, epidermal necrosis, and acantholysis, as well as multinucleate keratinocytes with margination of chromatin and nuclear molding (Figure 2).
Psoriasis herpeticum. Biopsy specimen from Figure 2 showing positivity with HSV type I immunoperoxidase staining (herpes simplex virus type I immunoperoxidase stain; original magnification: x200).
CRIOG2016-5319425.003.jpg
PMC5093277_01_CRIOG2016-5319425.003.jpg
fig3
Immunoperoxidase staining by monoclonal antibody for HSV type I and type II was positive, in keeping with the frequent cross-reactivity encountered with these antibody preparations (Figure 3).