Two men with folliculitis in the beard area caused by herpes simplex virus (HSV) are presented. The diagnosis of herpetic folliculitis was established by recovery of HSV on tissue culture and identification by complement-fixation and neutralization tests. Clinically, a burning sensation preceded the rapid development of grouped vesicular lesions; satellite vesiculofollicular lesions were diagnostic. One patient had a history of recurrent herpes labialis. Biopsies from both patients showed characteristic changes of a viral infection with epithelial multinucleated giant cells and ballooning degeneration of the surface epithelium and the epithelium of the external root sheath. Tzanck smears (Giesma stained) from lesions revealed numerous epithelial multinucleated giant cells. It is proposed that this folliculitis be called herpetic sycosis to emphasize its inclusion in the differential diagnosis of folliculitis in the beard area.
Allan K. Izumi, Robert Kim, Harry Arnold. Herpetic SycosisReport of Two Cases. Arch Dermatol. 1972;106(3):372–374. doi:10.1001/archderm.1972.01620120056012