Syringitis: A clue to herpes infection

Herpes simplex virus (HSV) is a member of the herpes virus family that commonly affects the skin. Typical histopathologic findings are usually limited to the epidermis and include intraepidermal vesicles or ulceration and epidermal necrosis. More specific findings in herpes virus infection include enlarged and pale keratinocytes, with steel-gray nuclei and margination of chromatin at the edge of the nucleus and ballooning degeneration. Although histopathologic changes may occasionally involve the hair follicles or sebaceous glands, it is very rare to find HSV involving the eccrine glands. We present a case of a 13-month-old child with a large body burn diagnosed with HSV (in the absence of the epidermis) by the presence of syringitis with herpetic features in the absence of the epidermis to aid in diagnosis.