Herpetic folliculitis: a lesser-known folliculitis and a review of herpes infections

Abstract

Herpetic folliculitis is a rare disease that involves the pilosebaceous units. It is caused by varicella zoster virus or by herpes simplex virus. It is an infrequently reported entity in literature. Presentations of this disease are quite variable and it can mimic several other more common diseases such as acne, gram negative folliculitis, demodicosis and pustular rosacea, often leading to misdiagnosis and incorrect or delayed treatment. Diagnosis using bedside tests like Tzanck smear, serological tests for herpes and skin biopsy wherever necessary can aid in the early diagnosis and timely intervention in this condition. Herpetic folliculitis can be considered as a sign of immunosuppression and its presence warrants screening for the same. We hereby report a case of herpetic folliculitis in an anemic 23-year-old female patient admitted in a tertiary care hospital with predominantly unilateral pustular, follicular oriented lesions on the right side of her face, unexplained fever and headache.