Background: Systemic lupus erythematosus is an autoimmune disease and genital herpes is a viral disease which can be aggravated during immunocompromised state. Case Report: A 45 years old female presented with rash in her buttocks for five years. She was a known case of SLE and was under immunosuppressive treatment for six years. The lesion on her buttocks were associated with mild pain but without itching. Lesions were erythematous with blisters and scab formation which were previously diagnosed at local hospital as erythematosus pemphigus. Histopathology and HSV -2 DNA testing by immunofluorescent method confirmed the diagnosis. Conclusion: This case illustrates diagnosis of atypical viral presentations in immunosuppressive people can be challenging. Viral antibody titers can give false negative results in immunocompromised patients.