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Hailey-Hailey, HSV, eczema herpeticum, dermatologic emergency
A 51-year-old man with a history of Hailey-Hailey disease presented to clinic due to worsening discomfort from a rash in his groin. Physical examination of the inguinal area and scrotum revealed grouped, punched-out ulcers on a base of macerated, erythematous plaques. Viral culture from the ulcers was positive for HSV-2. The patient had no known history of Herpesvirus infection. Treatment with oral valacyclovir resulted in marked clinical improvement. Although cases of Hailey-Hailey herpeticum are much less common than the better-studied eczema herpeticum, it is important for physicians to be aware that any disease that disrupts the stratum corneum increases the risk of superimposed HSV infection, which constitutes a medical emergency. Prompt treatment with antiviral agents can hasten patient recovery and optimize outcomes.