Background and Objective: Leukocytoclastic vasculitis (LCV) is a small vessel vasculitis
that can be limited to the skin but may also affect other organs. Often, its cause is unknown. LCV has
previously been reported to occur with the reactivation of human herpesvirus 6 (HHV-6). Here, we
report a second instance of HHV-6 reactivation in a 43-year-old woman with idiopathic cutaneous
Case Description: In this case, the patient was immunocompetent, and testing revealed that she had
inherited chromosomally integrated human herpesvirus 6 variant A (iciHHV6-A) with a parallel skin
infection of HHV-6B. The integrated ciHHV-6A strain was found to be transcriptionally active in the
blood, while HHV-6B late antigen was detected in a skin biopsy. The patient’s rash was not accompanied
by fever nor systemic symptoms and resolved over four weeks without any therapeutic intervention.
Conclusion: In light of the transcriptional activity documented in our case, further examination of a
possible role for HHV-6 in the etiology of LCV is warranted.