Generalized Hailey-Hailey Disease Complicated by MRSA Infection: A Case Report of Management with Systemic Corticosteroids and Targeted Anti-Infective Therapy

Purpose

Generalized cutaneous involvement is an uncommon presentation of Hailey-Hailey disease (HHD), and secondary bacterial infection may further complicate its management. We report a case of generalized HHD complicated by methicillin-resistant Staphylococcus aureus (MRSA) infection. Patients and methods: A 38-year-old man presented with a five-year history of recurrent flexural eruptions and a generalized exacerbation during the preceding two weeks. The clinical presentation and histopathological findings of acantholysis with intraepidermal blister formation supported the diagnosis of HHD. Direct immunofluorescence was negative for IgG and C3. Genetic testing was not performed. Cultures of skin exudates from multiple lesions revealed growth of MRSA. Treatment included systemic corticosteroids, oral moxifloxacin, topical agents, and local skin care. Moxifloxacin was selected according to the antimicrobial susceptibility results.