Which histologic findings are characteristic of herpes simplex virus (HSV) infection?

Updated: Mar 17, 2020
  • Author: Sean P McGregor, DO, PharmD; Chief Editor: William D James, MD  more...
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Cells infected with herpes simplex virus (HSV) demonstrate ballooning and reticular epidermal degeneration, epidermal acantholysis, and intraepidermal vesicles. Intranuclear inclusion bodies, steel-gray nuclei, multinucleate giant keratinocytes, and multilocular vesicles may also be present. Epidermal necrosis and an inflammatory infiltrate of lymphocytes and neutrophils may be observed. Additionally, up to one third of biopsy specimens may contain eosinophils. [50]  Histologic examination alone is unable to differentiate between subtypes of HSV. Immunoperoxidase techniques may be used to distinguish HSV-1 and HSV-2 antigens in formalin-fixed tissue samples.

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