Relapsing herpes simplex-2 folliculitis in the beard area

We describe the case of a 52-year-old immunocompetent man with recurrent folliculitis on the left cheek, associated with intense pain. Bacteriological, mycological and Tzanck tests from the lesions were negative. Histopathological study showed an aspecific flogosis pattern. Virological tests carried out on swabs and paraffin-embedded tissue sections from the facial lesions by nested PCR technique (nPCR) demonstrated the presence of herpes simplex virus type 2 (HSV\2) in both samples. Skin swabs from other healthy areas of the face resulted negative for herpetic infection. A diagnosis of recurrent herpetic folliculitis by HSV\2 was made. This case report underlines that even in immunocompetent patients HSV\2 lesions can feature atypical clinical aspects. In dermatological assessment the benefits of routine PCR techniques for differential diagnosis of herpetic infection should be considered above all for the prompt initiation of antiviral therapy and appropriate patient management.