A 51-year-old male patient with a history of non-Hodgkin's lymphoma diagnosed 2 years earlier.
The initial management of this disease included a combination of radiotherapy and chemotherapy, followed by autologous bone marrow transplantation with poor response.
She presented recurrence and splenic involvement and was treated with chemotherapy.
Pathological evaluation was requested due to a one-month history of extensive follicular papules, some with necrotic center, asymptomatic, on the scalp and extremities.
At the time of consultation he was in his third cycle of combined therapy COPDH (etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin).
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The histopathological study revealed an inflammatory infiltrate predominantly lymphocytic and neutrophilic, perivascular, superficial and deep and interstitial with leukocytoclasia, fibrinoid necrosis, microthrombi and red blood cell extravasation.
He had extensive necrosis of hair follicles with exudates fibrinolytic and keratinocytes mono and multinucleated with viral inclusions of herpetic type.
The clinical and histopathological findings described were compatible with necrotizing herpetic foci.
The patient was treated with valproate oral 1 g every 8 h with remission of skin lesions.
