What are the signs and symptoms of herpes simplex virus (HSV) infections?

Answer

Localized or disseminated eczema herpeticum is also known as Kaposi varicelliform eruption. Caused by HSV-1, eczema herpeticum is a variant of HSV infection that commonly develops in patients with atopic dermatitis, burns, or other inflammatory skin conditions. Atopic dermatitis is associated with a breakdown in the skin barrier and immune dysregulation, which can lead to cutaneous infections, such as, eczema herpeticum. Cutaneous infections in patients with atopic dermatitis lead to increased emergency department utilization, and both pediatric and adult patients have higher odds of an HSV infection.^[35]Children are most commonly affected by eczema herpeticum, and it is more commonly associated with younger age and black or Asian race.^[36]Eczema herpeticum can be diagnostically challenging, and the mean time to diagnosis is approximately 4 days.^[37]Both primary and secondary HSV infections can lead to eczema herpeticum, and there is a 26.5% recurrence rate observed.^[37]A retrospective study of 180 hospitalized patients with atopic dermatitis found that fever on admission, a rash on the neck, and a vesicular eruption were the clinical features associated with eczema herpeticum and these patients had a longer hospital length of stay.^[38]

Additionally, HSV infection can complicate other cutaneous diseases associated with a breakdown in the skin barrier, such as pemphigus vulgaris. A hospital-based study of 60 patients with pemphigus vulgaris found that the presence of hemorrhagic crusting and linear erosions were associated with HSV infection.^[39]

Herpetic whitlow, characterized by vesicular outbreaks on the hands and the digits, was most commonly due to infection with HSV-1. It usually occurred in children who sucked their thumbs and, prior to the widespread use of gloves, in dental and medical health care workers. The occurrence of herpetic whitlow due to HSV-2 is increasingly recognized, probably due to digital-genital contact.

Herpes gladiatorum is caused by HSV-1 and is seen as papular or vesicular eruptions on the face, arms, or torsos of athletes in sports involving close physical contact (classically associated with wrestling).

Disseminated HSV infection can occur in females who are pregnant and in individuals who are immunocompromised. These patients may present with atypical signs and symptoms of HSV, and the condition may be difficult to diagnose.

Herpetic sycosis, a follicular infection with HSV, may present as a vesiculopustular eruption on the beard area. This infection often results from autoinoculation after shaving through a recurrent herpetic outbreak. Classically caused by HSV-1, there have been rare reports of relapsing beard folliculitis caused by HSV-2.^[40]

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Roizman B, Whitley RJ. An inquiry into the molecular basis of HSV latency and reactivation. Annu Rev Microbiol. 2013. 67:355-74. [Medline].
Komala Sari T, Gianopulos KA, Nicola AV. Glycoprotein C of Herpes Simplex Virus 1 Shields Glycoprotein B from Antibody Neutralization. J Virol. 2020 Feb 14. 94 (5):[Medline].
Hensel MT, Peng T, Cheng A, De Rosa SC, Wald A, Laing KJ, et al. Selective Expression of CCR10 and CXCR3 by Circulating Human Herpes Simplex Virus-Specific CD8 T Cells. J Virol. 2017 Oct 1. 91 (19):[Medline].
Margolis TP, Imai Y, Yang L, Vallas V, Krause PR. Herpes simplex virus type 2 (HSV-2) establishes latent infection in a different population of ganglionic neurons than HSV-1: role of latency-associated transcripts. J Virol. 2007 Feb. 81(4):1872-8. [Medline].
Weinberg JM, Mysliwiec A, Turiansky GW, Redfield R, James WD. Viral folliculitis. Atypical presentations of herpes simplex, herpes zoster, and molluscum contagiosum. Arch Dermatol. 1997 Aug. 133(8):983-6. [Medline].
Zoghaib S, Kechichian E, Souaid K, Soutou B, Helou J, Tomb R. Triggers, clinical manifestations, and management of pediatric erythema multiforme: A systematic review. J Am Acad Dermatol. 2019 Sep. 81 (3):813-822. [Medline].
Bradley H, Markowitz LE, Gibson T, McQuillan GM. Seroprevalence of herpes simplex virus types 1 and 2--United States, 1999-2010. J Infect Dis. 2014 Feb 1. 209 (3):325-33. [Medline].
Centers for Disease Control and Prevention (CDC). Seroprevalence of herpes simplex virus type 2 among persons aged 14-49 years--United States, 2005-2008. MMWR Morb Mortal Wkly Rep. 2010 Apr 23. 59 (15):456-9. [Medline].
Centers for Disease Control and Prevention. 2016 Sexually Transmitted Diseases Surveillance - Other Sexually Transmitted Diseases. Available at https://www.cdc.gov/std/stats16/other.htm. September 26, 2017; Accessed: December 5, 2017.
Gottlieb SL, Douglas JM Jr, Schmid DS, Bolan G, Iatesta M, Malotte CK, et al. Seroprevalence and correlates of herpes simplex virus type 2 infection in five sexually transmitted-disease clinics. J Infect Dis. 2002 Nov 15. 186 (10):1381-9. [Medline].
Roberts CM, Pfister JR, Spear SJ. Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sex Transm Dis. 2003 Oct. 30 (10):797-800. [Medline].
Hellenbrand W, Thierfelder W, Müller-Pebody B, Hamouda O, Breuer T. Seroprevalence of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in former East and West Germany, 1997-1998. Eur J Clin Microbiol Infect Dis. 2005 Feb. 24(2):131-5. [Medline].
Singh AE, Romanowski B, Wong T, Gourishankar S, Myziuk L, Fenton J, et al. Herpes simplex virus seroprevalence and risk factors in 2 Canadian sexually transmitted disease clinics. Sex Transm Dis. 2005 Feb. 32(2):95-100. [Medline].
Korr G, Thamm M, Czogiel I, Poethko-Mueller C, Bremer V, Jansen K. Decreasing seroprevalence of herpes simplex virus type 1 and type 2 in Germany leaves many people susceptible to genital infection: time to raise awareness and enhance control. BMC Infect Dis. 2017 Jul 6. 17 (1):471. [Medline].
Woestenberg PJ, Tjhie JH, de Melker HE, van der Klis FR, van Bergen JE, van der Sande MA, et al. Herpes simplex virus type 1 and type 2 in the Netherlands: seroprevalence, risk factors and changes during a 12-year period. BMC Infect Dis. 2016 Aug 2. 16:364. [Medline].
Marchi S, Trombetta CM, Gasparini R, Temperton N, Montomoli E. Epidemiology of herpes simplex virus type 1 and 2 in Italy: a seroprevalence study from 2000 to 2014. J Prev Med Hyg. 2017 Mar. 58 (1):E27-E33. [Medline].
Looker KJ, Magaret AS, May MT, Turner KM, Vickerman P, Gottlieb SL, et al. Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS One. 2015. 10 (10):e0140765. [Medline].
Looker KJ, Magaret AS, Turner KM, Vickerman P, Gottlieb SL, Newman LM. Global estimates of prevalent and incident herpes simplex virus type 2 infections in 2012. PLoS One. 2015. 10 (1):e114989. [Medline].
Paz-Bailey G, Ramaswamy M, Hawkes SJ. Herpes simplex virus type 2: epidemiology and management options in developing countries. Sex Transm Infect. 2007 Feb. 83(1):16-22. [Medline]. [Full Text].
Levett PN. Seroprevalence of HSV-1 and HSV-2 in Barbados. Med Microbiol Immunol. 2005 Jan. 194(1-2):105-7. [Medline].
Xu F, Markowitz LE, Gottlieb SL, Berman SM. Seroprevalence of herpes simplex virus types 1 and 2 in pregnant women in the United States. Am J Obstet Gynecol. 2007 Jan. 196(1):43.e1-6. [Medline].
Kelly JD, Cohen J, Grimes B, Philip SS, Weiser SD, Riley ED. High Rates of Herpes Simplex Virus Type 2 Infection in Homeless Women: Informing Public Health Strategies. J Womens Health (Larchmt). 2016 Aug. 25 (8):840-5. [Medline].
Gittler JK, Mu EW, Orlow SJ. Characterization of Herpes Simplex Virus Infections Seen in the Pediatric Dermatology Office. Pediatr Dermatol. 2017 Jul. 34 (4):446-449. [Medline].
Ng PP, Sun YJ, Tan HH, Tan SH. Detection of herpes simplex virus genomic DNA in various subsets of Erythema multiforme by polymerase chain reaction. Dermatology. 2003. 207 (4):349-53. [Medline].
Austin A, Lietman T, Rose-Nussbaumer J. Update on the Management of Infectious Keratitis. Ophthalmology. 2017 Nov. 124 (11):1678-1689. [Medline].
Rabinstein AA. Herpes Virus Encephalitis in Adults: Current Knowledge and Old Myths. Neurol Clin. 2017 Nov. 35 (4):695-705. [Medline].
Klausner JD, Kohn R, Kent C. Etiology of clinical proctitis among men who have sex with men. Clin Infect Dis. 2004 Jan 15. 38 (2):300-2. [Medline].
Bissessor M, Fairley CK, Read T, Denham I, Bradshaw C, Chen M. The etiology of infectious proctitis in men who have sex with men differs according to HIV status. Sex Transm Dis. 2013 Oct. 40 (10):768-70. [Medline].
Baeten JM, Strick LB, Lucchetti A, Whittington WL, Sanchez J, Coombs RW, et al. Herpes simplex virus (HSV)-suppressive therapy decreases plasma and genital HIV-1 levels in HSV-2/HIV-1 coinfected women: a randomized, placebo-controlled, cross-over trial. J Infect Dis. 2008 Dec 15. 198(12):1804-8. [Medline]. [Full Text].
Bruno E, Pillus D, Cheng D, Vilke G, Pokrajac N. During the Emergency Department Evaluation of a Well-Appearing Neonate with Fever, Should Empiric Acyclovir Be Initiated?. J Emerg Med. 2017 Nov 29. [Medline].
Li Puma DD, Piacentini R, Leone L, Gironi K, Marcocci ME, De Chiara G, et al. Herpes Simplex Virus Type-1 Infection Impairs Adult Hippocampal Neurogenesis via Amyloid-β Protein Accumulation. Stem Cells. 2019 Nov. 37 (11):1467-1480. [Medline].
Linard M, Letenneur L, Garrigue I, Doize A, Dartigues JF, Helmer C. Interaction between APOE4 and herpes simplex virus type 1 in Alzheimer's disease. Alzheimers Dement. 2020 Jan. 16 (1):200-208. [Medline].
Boivin G, Goyette N, Sergerie Y, Keays S, Booth T. Longitudinal evaluation of herpes simplex virus DNA load during episodes of herpes labialis. J Clin Virol. 2006 Dec. 37(4):248-51. [Medline].
Dabestani N, Katz DA, Dombrowski J, Magaret A, Wald A, Johnston C. Time Trends in First-Episode Genital Herpes Simplex Virus Infections in an Urban Sexually Transmitted Disease Clinic. Sex Transm Dis. 2019 Dec. 46 (12):795-800. [Medline].
Ren Z, Silverberg JI. Association of Atopic Dermatitis With Bacterial, Fungal, Viral, and Sexually Transmitted Skin Infections. Dermatitis. 2020 Feb 10. [Medline].
Hsu DY, Shinkai K, Silverberg JI. Epidemiology of Eczema Herpeticum in Hospitalized U.S. Children: Analysis of a Nationwide Cohort. J Invest Dermatol. 2018 Feb. 138 (2):265-272. [Medline].
Seegräber M, Worm M, Werfel T, Svensson A, Novak N, Simon D, et al. Recurrent eczema herpeticum - a retrospective European multicenter study evaluating the clinical characteristics of eczema herpeticum cases in atopic dermatitis patients. J Eur Acad Dermatol Venereol. 2019 Nov 16. [Medline].
Hemani SA, Edmond MB, Jaggi P, Cooley A. Frequency and Clinical Features Associated With Eczema Herpeticum in Hospitalized Children With Presumed Atopic Dermatitis Skin Infection. Pediatr Infect Dis J. 2020 Feb 14. [Medline].
Konda D, Chandrashekar L, Dhodapkar R, Ganesh RN, Thappa DM. Clinical Markers of Herpes Simplex Virus Infection in Patients with Pemphigus Vulgaris. J Am Acad Dermatol. 2019 Jun 10. [Medline].
Foti C, Filotico R, Calvario A, Conserva A, Antelmi A, Angelini G. Relapsing herpes simplex-2 folliculitis in the beard area. Eur J Dermatol. 2004 Nov-Dec. 14(6):421-3. [Medline].
Pomerantz H, Wang H, Heilman ER, Sharon VR, Gottesman SP. Peculiar vegetative tumor-like genital herpes simplex nodules with brisk tissue eosinophilia in patients with human immunodeficiency virus infection. J Cutan Pathol. 2020 Feb. 47 (2):150-153. [Medline].
Sasso BM, Florence MEB, Magalhaes RF, Velho PENF, de Souza EM, Cintra ML, et al. Herpes simplex virus mucocutaneous tumoural lesions - Systematic review. J Clin Virol. 2020 Feb. 123:104246. [Medline].
Fernandes ND, Sthapit B, Mhanna M, Abughali N. Evaluation of suspected neonatal herpes simplex virus infection in preterm versus term newborns in the neonatal intensive care unit. J Neonatal Perinatal Med. 2020 Feb 20. [Medline].
Davis A, Gaynor A. Testing for Sexually Transmitted Diseases in US Public Health Laboratories, 2016. Sex Transm Dis. 2020 Feb. 47 (2):122-127. [Medline].
Faron ML, Ledeboer NA, Patel A, Beqa SH, Yen-Lieberman B, Kohn D, et al. Multicenter Evaluation of Meridian Bioscience HSV 1&2 Molecular Assay for Detection of Herpes Simplex Virus 1 and 2 from Clinical Cutaneous and Mucocutaneous Specimens. J Clin Microbiol. 2016 Aug. 54 (8):2008-13. [Medline].
Swenson PD, El-Sabaeny A, Thomas-Moricz V, Allen M, Groskopf A, Jiang A, et al. Evaluation of a transcription mediated amplification assay for detection of herpes simplex virus types 1 and 2 mRNA in clinical specimens. J Clin Virol. 2016 Jul. 80:62-7. [Medline].
Ramaswamy M, McDonald C, Smith M, Thomas D, Maxwell S, Tenant-Flowers M, et al. Diagnosis of genital herpes by real time PCR in routine clinical practice. Sex Transm Infect. 2004 Oct. 80 (5):406-10. [Medline].
[Guideline] Centers for Disease Control and Prevention. 2015 Sexually Transmitted Diseases Treatment Guidelines. Available at https://www.cdc.gov/std/tg2015/default.htm. January 25, 2017; Accessed: December 5, 2017.
Kaufman HE, Azcuy AM, Varnell ED, Sloop GD, Thompson HW, Hill JM. HSV-1 DNA in tears and saliva of normal adults. Invest Ophthalmol Vis Sci. 2005 Jan. 46(1):241-7. [Medline].
Laggis C, Wada D, Shah A, Zussman J. Eosinophils are surprisingly common in biopsy specimens of cutaneous herpes simplex virus and varicella zoster virus infections: Results of a comprehensive histopathologic and clinical appraisal. J Cutan Pathol. 2020 Jan. 47 (1):6-11. [Medline].
Amir J, Harel L, Smetana Z, Varsano I. Treatment of herpes simplex gingivostomatitis with aciclovir in children: a randomised double blind placebo controlled study. BMJ. 1997 Jun 21. 314 (7097):1800-3. [Medline].
Spruance SL, Bodsworth N, Resnick H, Conant M, Oeuvray C, Gao J, et al. Single-dose, patient-initiated famciclovir: a randomized, double-blind, placebo-controlled trial for episodic treatment of herpes labialis. J Am Acad Dermatol. 2006 Jul. 55 (1):47-53. [Medline].
Baker D, Eisen D. Valacyclovir for prevention of recurrent herpes labialis: 2 double-blind, placebo-controlled studies. Cutis. 2003 Mar. 71 (3):239-42. [Medline].
Benedetti J, Corey L, Ashley R. Recurrence rates in genital herpes after symptomatic first-episode infection. Ann Intern Med. 1994 Dec 1. 121 (11):847-54. [Medline].
Gupta R, Warren T, Wald A. Genital herpes. Lancet. 2007 Dec 22. 370 (9605):2127-37. [Medline].
Corey L, Wald A, Patel R, Sacks SL, Tyring SK, Warren T, et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med. 2004 Jan 1. 350 (1):11-20. [Medline].
Abudalu M, Tyring S, Koltun W, Bodsworth N, Hamed K. Single-day, patient-initiated famciclovir therapy versus 3-day valacyclovir regimen for recurrent genital herpes: a randomized, double-blind, comparative trial. Clin Infect Dis. 2008 Sep 1. 47 (5):651-8. [Medline].
Levin MJ, Bacon TH, Leary JJ. Resistance of herpes simplex virus infections to nucleoside analogues in HIV-infected patients. Clin Infect Dis. 2004 Nov 1. 39 Suppl 5:S248-57. [Medline].
Epstein JB, Gharapetian S, Rejali AR, Zabner R, Lill M, Tzachanis D. Complex management of resistant oral herpes simplex virus infection following hematopoietic stem cell transplantation: potential role of topical cidofovir. Support Care Cancer. 2016 Aug. 24 (8):3603-6. [Medline].
Muluneh B, Dean A, Armistead P, Khan T. Successful clearance of cutaneous acyclovir-resistant, foscarnet-refractory herpes virus lesions with topical cidofovir in an allogeneic hematopoietic stem cell transplant patient. J Oncol Pharm Pract. 2013 Jun. 19 (2):181-5. [Medline].
Mark KE, Spruance S, Kinghorn GR, Sacks SL, Slade HB, Meng TC, et al. Three phase III randomized controlled trials of topical resiquimod 0.01-percent gel to reduce anogenital herpes recurrences. Antimicrob Agents Chemother. 2014 Sep. 58 (9):5016-23. [Medline].
Subramaniam A, Britt WJ. Herpesviridae Infection: Prevention, Screening, and Management. Clin Obstet Gynecol. 2018 Mar. 61 (1):157-176. [Medline].
Spruance SL, Nett R, Marbury T, Wolff R, Johnson J, Spaulding T. Acyclovir cream for treatment of herpes simplex labialis: results of two randomized, double-blind, vehicle-controlled, multicenter clinical trials. Antimicrob Agents Chemother. 2002 Jul. 46 (7):2238-43. [Medline].
Hull CM, Harmenberg J, Arlander E, Aoki F, Bring J, Darpö B, et al. Early treatment of cold sores with topical ME-609 decreases the frequency of ulcerative lesions: A randomized, double-blind, placebo-controlled, patient-initiated clinical trial. J Am Acad Dermatol. 2011 Apr. 64(4):696.e1-696.e11. [Medline].
Sacks SL, Thisted RA, Jones TM, Barbarash RA, Mikolich DJ, Ruoff GE, et al. Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: A multicenter, randomized, placebo-controlled trial. J Am Acad Dermatol. 2001 Aug. 45 (2):222-30. [Medline].
Silverberg NB, Durán-McKinster C. Special Considerations for Therapy of Pediatric Atopic Dermatitis. Dermatol Clin. 2017 Jul. 35 (3):351-363. [Medline].
Tatnall FM, Schofield JK, Leigh IM. A double-blind, placebo-controlled trial of continuous acyclovir therapy in recurrent erythema multiforme. Br J Dermatol. 1995 Feb. 132 (2):267-70. [Medline].
Rooney JF, Bryson Y, Mannix ML, Dillon M, Wohlenberg CR, Banks S, et al. Prevention of ultraviolet-light-induced herpes labialis by sunscreen. Lancet. 1991 Dec 7. 338 (8780):1419-22. [Medline].
Shamsaldeen O, Peterson JD, Goldman MP. The adverse events of deep fractional CO(2): a retrospective study of 490 treatments in 374 patients. Lasers Surg Med. 2011 Aug. 43 (6):453-6. [Medline].
Bisaccia E, Scarborough D. Herpes simplex virus prophylaxis with famciclovir in patients undergoing aesthetic facial CO2 laser resurfacing. Cutis. 2003 Oct. 72 (4):327-8. [Medline].
Hosken NA. Development of a therapeutic vaccine for HSV-2. Vaccine. 2005 Mar 18. 23(17-18):2395-8. [Medline].
Awasthi S, Hook LM, Shaw CE, Friedman HM. A trivalent subunit antigen glycoprotein vaccine as immunotherapy for genital herpes in the guinea pig genital infection model. Hum Vaccin Immunother. 2017 Dec 2. 13 (12):2785-2793. [Medline].
Stanberry LR, Spruance SL, Cunningham AL, Bernstein DI, Mindel A, Sacks S, et al. Glycoprotein-D-adjuvant vaccine to prevent genital herpes. N Engl J Med. 2002 Nov 21. 347(21):1652-61. [Medline].
Du R, Wang L, Xu H, Wang Z, Zhang T, Wang M, et al. A novel glycoprotein D-specific monoclonal antibody neutralizes herpes simplex virus. Antiviral Res. 2017 Nov. 147:131-141. [Medline].
Gupta R, Wald A, Krantz E, Selke S, Warren T, Vargas-Cortes M, et al. Valacyclovir and acyclovir for suppression of shedding of herpes simplex virus in the genital tract. J Infect Dis. 2004 Oct 15. 190(8):1374-81Epub 2004 Sep 20. [Medline].
Mayaud P, Legoff J, Weiss HA, Grésenguet G, Nzambi K, Bouhlal H, et al. Impact of acyclovir on genital and plasma HIV-1 RNA, genital herpes simplex virus type 2 DNA, and ulcer healing among HIV-1-infected African women with herpes ulcers: a randomized placebo-controlled trial. J Infect Dis. 2009 Jul 15. 200(2):216-26. [Medline].
Nagot N, Ouedraogo A, Konate I, Weiss HA, Foulongne V, Defer MC, et al. Roles of clinical and subclinical reactivated herpes simplex virus type 2 infection and human immunodeficiency virus type 1 (HIV-1)-induced immunosuppression on genital and plasma HIV-1 levels. J Infect Dis. 2008 Jul 15. 198(2):241-9. [Medline].
Ouedraogo A, Nagot N, Vergne L, Konate I, Weiss HA, Defer MC, et al. Impact of suppressive herpes therapy on genital HIV-1 RNA among women taking antiretroviral therapy: a randomized controlled trial. AIDS. 2006 Nov 28. 20(18):2305-13. [Medline].
Scott LL, Hollier LM, McIntire D, Sanchez PJ, Jackson GL, Wendel GD. Acyclovir suppression to prevent clinical recurrences at delivery after first episode genital herpes in pregnancy: an open-label trial. Infect Dis Obstet Gynecol. 2001. 9(2):75-80. [Medline].
Pasternak B, Hviid A. Use of acyclovir, valacyclovir, and famciclovir in the first trimester of pregnancy and the risk of birth defects. JAMA. 2010 Aug 25. 304(8):859-66. [Medline].
Lee R, Nair M. Diagnosis and treatment of herpes simplex 1 virus infection in pregnancy. Obstet Med. 2017 Jun. 10 (2):58-60. [Medline].
Barclay L. ACOG recommends expedited partner therapy for STIs. Medscape Medical News. Available at http://www.medscape.com/viewarticle/845221. May 22, 2015; Accessed: June 24, 2015.
[Guideline] American College of Obstetricians and Gynecologists. Committee opinion no 632: expedited partner therapy in the management of gonorrhea and chlamydial infection. Obstet Gynecol. 2015 Jun. 125 (6):1526-8. [Medline].

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Characteristic cluster of vesicles on an erythematous base. Photo courtesy of Dr. John Reeves.

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Author

Sean P McGregor, DO, PharmD Resident Physician, Department of Dermatology, Baptist Health Medical Center, Wake Forest University School of Medicine

Sean P McGregor, DO, PharmD is a member of the following medical societies: American Academy of Dermatology, American Osteopathic College of Dermatology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, American Society of Health-System Pharmacists, Sigma Sigma Phi

Disclosure: Nothing to disclose.

Coauthor(s)

William W Huang, MD, MPH, FAAD Associate Professor and Residency Program Director, Department of Dermatology, Wake Forest Baptist Health, Wake Forest University School of Medicine

William W Huang, MD, MPH, FAAD is a member of the following medical societies: American Academy of Dermatology, Association of Professors of Dermatology, Dermatology Foundation, Medical Dermatology Society, North Carolina Medical Society, Women's Dermatologic Society

Disclosure: Research PI for Sponsored Trial for: Gilead; Genentech;.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD.

Additional Contributors

Joseph S Eastern, MD Clinical Assistant Professor, Department of Internal Medicine, Section of Dermatology, University of Medicine and Dentistry of New Jersey; Clinical Assistant Professor, Seton Hall University School of Graduate Medical Education

Joseph S Eastern, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, International Society for Dermatologic Surgery, Medical Society of New Jersey

Disclosure: Nothing to disclose.

Sungnack Lee, MD Vice President of Medical Affairs, Professor, Department of Dermatology, Ajou University School of Medicine, Korea

Sungnack Lee, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Malcolm Schinstine, MD, PhD; Paul Krusinski, MD; Gisela Torres, MD; and Stephen K Tyring, MD, PhD, MBA, to the development and writing of this article.

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