Low-productive alpha-herpesviridae infection in chronic lichenoid dermatoses

BACKGROUND: Herpes simplex virus (HSV) and Varicella-zoster virus (VZV) are responsible for various atypical mucocutaneous manifestations in the immunosuppressed population. One of the causative pathomechanisms suggests an altered virus-host cell relationship. OBJECTIVE/METHODS: This report investigates by histology, immunohistochemistry and in situ hybridization the histological and virological features of 6 protracted, indolent HSV infections and 2 prolonged zoster infections. RESULTS: Histopathology revealed a lichenoid dermatitis in all patients. Specific HSV-1, HSV-2 and VZV in situ hybridization proved the viral origin of the cutaneous lesions. Immunohistochemical assessment demonstrated the intracellular presence of the HSV glycoproteins gB, gC and gD in epidermal keratinocytes which did not exhibit cytolysis. Similar findings were obtained for the VZV gE and gB. CONCLUSION: These results suggest that in some instances HSV and VZV infections may present a protracted disease course associated with a lichenoid inflammatory pattern and a non-cytolytic virus-host cell relationship.