Recurrent herpes simplex virus cellulitis of the right forearm with early elephantiasis responsive to both treatment and prophylaxis by valacyclovir

Recurrent herpes simplex virus (HSV-1 or HSV-2) infections of the lips, fin gers (whitlow), eye (keratoconjunctivitis), genitals, vulva, cervix, buttoc ks, or skin (eczema herpeticum, herpes gladiatorum) are common [1,2]. HSV-1 or HSV-2 infections may develop on the extremities and may be accompanied by lymphangitis and local edema. Recurring infections are the result of per sistent infection in adjacent neuronal ganglia (usually sensory ganglia) wi th intermittent axonal spread to the skin [2-5]. This case of recurrent swe lling with erythema of the right forearm accompanied by episodes of fever, diarrhea, and progressive swelling of the arm resembled streptococcal or st aphylococcal erysipelas, I could find no similar report.