ABSTRACT
Herpes folliculitis is a herpes virus infection that can present as erythematous papules and plaques without the characteristic epidermal change of vesicles found in most herpetic infections. Because of its atypical clinical features, herpes folliculitis is often misdiagnosed, and histopathologic findings are important in diagnosis of the condition. Histopathologic features of herpetic folliculitis show ballooning, multinucleated giant cells and keratinocytes with steel gray nuclei in the follicular epithelium. A 61-year-old Korean male presented with erythematous, painful nodules on his left cheek and chin. Initially, a lesion first developed on his chin after shaving with a razor blade, then spread to the left cheek in a linear distribution. Physical examination revealed a 1x1 cm sized erythematous nodule on the chin, and 1 x 1.5 cm sized erythematous nodules on the left cheek. Histopathologic examination showed typical herpetic cytopathic features. A PCR study was performed and the result was positive for HSV-1. The patient was treated with 750 mg of famciclovir per day and the lesions improved after 7 days of treatment. Herein, we present a case of herpetic folliculitis in a 61-year-old Korean male, and propose that physicians should consider herpetic viral etiology in patients with folliculitis if they show resistance to antibacterial and antifungal therapy.