A cutaneous herpes simplex virus (HSV) infection is a common complication of Hailey-Hailey disease, causing an exacerbation of the disease. The patient described had an exacerbation of Hailey-Hailey disease in the inguinal region caused by an HSV-1 infection during topical treatment with tacrolimus 0,1% ointment, probably due to auto-inoculation from relapsing herpes labialis during an asymptomatic period. It is unknown whether tacrolimus increases the risk of activation of a cutaneous HSV infection in M. Hailey-Hailey. That risk appears not to be increased in atopic dermatitis. The literature suggests, that tacrolimus should not be started in patients with an active cutaneous viral infection and that it should be stopped (temporarily) in the occurrence of active infection.
