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The biopsy specimen from the patient's right eyelid showed an epidermis with an ulcerated surface. The base of the ulcer contained cells with nuclei demonstrating the characteristic features of herpetic infection: marginated chromatin, nuclear molding, and occasional multinucleated forms (Figure 3). A culture was positive for HSV, and valacyclovir hydrochloride therapy (500 mg twice a day) was begun. The patient experienced marked improvement within 24 hours.
Bilateral Periorbital Eruption in an Immunocompromised Host—Diagnosis. Arch Dermatol. 2003;139(2):215-220. doi:10.1001/archderm.139.2.215-h