Human papillomavirus type 5 infection in a patient with Hailey?Hailey disease successfully treated with imiquimod

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Conflicts of interest: none declared. Sir, Hailey–Hailey disease, also known as familial benign pemphigus (FBP), is a rare autosomal dominantly inherited blistering disease characterized by recurrent vesicles and erosions, particularly involving flexural areas. The major underlying pathological process in FBP is acantholysis of keratinocytes caused by mutations in the genes encoding the Golgi secretory pathway Ca2+‐ATPase (SPCA1, ATP2C1), affecting cell–cell adhesion. It is not uncommon for patients with FBP to have secondary bacterial infection. Nevertheless, FBP with human papillomavirus type 5 (HPV‐5) infection has not been reported in the literature. We report a patient with FBP with concomitant HPV‐5 infection successfully treated with topical imiquimod. To our knowledge, this is the first reported case of FBP associated with HPV‐5 infection. A 62‐year‐old Taiwanese man presented with a 15‐year history of recurrent itching and oozing rashes involving the scrotum and perineum. Two years prior to his first visit to our clinic, he started to notice asymptomatic papular eruptions at the perianal area. At the time, he was diagnosed and treated for tinea cruris and eczema. Nevertheless, the lesions did not show any response to the prescribed topical antifungal agents or topical corticosteroids.