Recurrent herpes infection showing a new facial phenotype: A case report

Abstract

BACKGROUND

Facial herpes is a common form of the herpes simplex virus-1 infection and usually presents as vesicles near the mouth, nose, and periocular sites. In contrast, we observed a new facial symptom of herpes on the entire face without vesicles.

CASE SUMMARY

A 33-year-old woman with a history of varicella infection and shingles since an early age presented with sarcoidosis of the entire face and neuralgia without oral lesions. The patient was prescribed antiviral treatment with valacyclovir and acyclovir cream. One day after drug administration, facial skin lesions and neurological pain improved. Herpes simplex without oral blisters can easily be misdiagnosed as pimples upon visual examination in an outpatient clinic.

CONCLUSION

As acute herpes simplex is accompanied by neuralgia, prompt diagnosis and prescription are necessary, considering the pathological history and health conditions.

Keywords: Facial herpes; Recurrent herpes infection; Cutaneous sarcoidosis; Herpes simplex virus; Herpes zoster; Varicella-zoster; Chicken pox; Immune system; Case report

Core Tip: Unlike common facial herpes, this case introduces a new pan-facial herpes symptom: Swollen redness on the patient’s entire face without herpetic vesicles. The patient had experienced recurrent infections with herpes simplex and herpes zoster viruses since the age of 7 years. On the visit day, the patient complained of headache and neuralgia; hence, a prompt antiviral prescription was advised based on the patient’s pathological history and current condition.