Recurrent herpes simplex in elderly with vitiligo vulgaris: A dilemmatic case

Herpes simplex is a viral infection that frequently recurs after treatment. We reported a case of recurrent herpetic lesion in a 61 year old elderly with vitiligo that routinely undergoes UVB phototherapy. The patient was previously diagnosed with vitiligo vulgaris and is already under narrowband UVB phototherapy since 18 months ago. The herpetic lesion appeared above the vitiligo area, therefore it was well-exposed to UVB phototherapy. There was no other disease or drug consumed. Upon treatment with oral and topical acyclovir, the herpetic lesion improved. Not long after however, the lesion continued to reappear after treatment, up to five times in the past year. Therefore, we increased the dose of acyclovir to 800 mg b.i.d. for 7 days, and protected the herpetic lesion during phototherapy until it resolved. Suggested treatment options include higher and longer periods of antiviral, herpetic lesion protection, and/or surgical nerve decompression.