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Postherpetic Nevocentric Erythema Multiforme.

Elizabeth Sutton1, Stephanie Sutton2, Christopher J Smith3

  • 1Department of Psychiatry, University of Nebraska Medical Center, Omaha, Nebraska.

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Summary

A woman developed itchy red spots around her moles, possibly linked to a prior herpes infection. These spots resolved spontaneously, followed by targetoid lesions on her hands.

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Area of Science:

  • Dermatology
  • Immunology

Background:

  • A healthy 35-year-old Caucasian woman with Fitzpatrick type I skin presented with multiple nevi.
  • She reported a recent history of recurrent herpes labialis.

Observation:

  • Abrupt onset of erythematous, mildly pruritic plaques surrounding nevi on her trunk and extremities.
  • Lesions ranged from 0.4 cm to 1.5 cm and resolved spontaneously within a week.
  • Targetoid lesions on dorsal hands appeared as trunk lesions improved, also resolving spontaneously.

Findings:

  • Biopsies were taken from a nevus and surrounding plaque.
  • The nevocentric erythematous plaques suggest an immune response.
  • The subsequent appearance of targetoid lesions indicates a potential systemic reaction.

Implications:

  • This case highlights a rare presentation possibly associated with herpes simplex virus reactivation.
  • Further investigation may elucidate the immunologic link between herpes labialis and nevus-associated dermatoses.
  • Understanding this association could lead to novel diagnostic or therapeutic approaches for similar cutaneous reactions.