Herpes Simplex Virus Infections of the Nipple

Lara El Hayderi, Marie Caucanas, Arjen F. Nikkels*
Department of Dermatology, University Hospital of Liège, Liège, Belgium

© 2012 El Hayderi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Dermatology, CHU of Sart Tilman, University of Liège, B-4000 Liège, Belgium; Tel: +32-43667232; Fax: +32-43667234; E-mail:


The usual sites of herpes simplex virus (HSV) type 1 and 2 infections are orolabial and anogenital, respectively. HSV infection of the nipple and periareolar area is exceptional but probably underrecognized. Typical features include severe pain and erosive or ulcerated erythematous confluent clusters of lesions of the nipple and periareolar area. It is usually unilateral and not recurring. HSV infection of the nipple is originating from autoinoculation, sexual transmission or breastfeeding. Diagnosis is often delayed. The Tzanck smear is the most rapid and adequate method of diagnosis. Immunohistochemistry enables viral identification. The treatment relies on topical disinfection and oral antiviral therapy, such as aciclovir, famciclovir or valaciclovir. Scarring is uncommon.

Keywords: Herpes simplex virus, nipple, areola, aciclovir..