A 45-year-old male presents with a recurrent, painful rash on his buttocks that appears as clusters of vesicles on a red base. He also complains of occasional tingling in that area before the rash appears. What is the likely cause, and how should it be managed?
This is likely a recurrent outbreak of herpes simplex, possibly HSV-2, presenting as herpes gladiatorum or "wrestler's herpes." Antiviral therapy can help to shorten the duration of the outbreak. For recurrent cases, suppressive daily antiviral therapy may be considered to reduce the frequency of outbreaks.