Case 141. Herpes simplex virus infection of vulva (28 y-o F)
Touch smear from painful vulvar ulceration
Key words : herpes simplex virus, vulvar ulcer
sexually transmitted infection
Multiple map-like erosions focally with bulla formation are seen in the vulva (gross findings). Acute infection of HSV, type 1 accompanying severe clinical manifestation, transmitted by oral sex, is suspected.   Squamous epithelia are often multinucleated and show intranuclear inclusion bodies. Groundglass (smudgy) nuclei are characteristic (Papanicolaou).
Haloed intranuclear inclusion of Cowdry's type A is infrequently encountered. Immunostaining using anti-HSV antiserum demonstrates positive signals in both the nuclei and cytoplasm (left: Papanicolaou, right: immunostaining by re-staining method).