eczema herpeticum
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Etiology
- Herpes simplex
- atopy, atoptic dermatitis
Epidemiology
- occurs in infants & adults
Clinical manifestations
- rapid onset of diffuse cutaneous Herpes simplex
- diffuse eruption of pruritic, umbilicated, erythematous vesicles with erosion & crusting
- vesicles may rupture to form erosions & coalesce to form larger ulcerations
- lesions develop on areas of pre-existing atopic dermatitis
- face, neck, upper torso
- lesions can spread to areas of normal skin within 1 week
- systemic manifestations of fever, malaise & lymphadenopathy may occur[3]
* images[2]
Laboratory
- cytology of unroofed vesicle shows giant, ballooned keratinocytes
- direct fluorescent antibody test for HSV
Complications
- bacterial superinfection
- can be life-threatening
Differential diagnosis
- impetigo, bullous impetigo
- scabies
- eczema vaccinatum
- primary varicella infection
Management
- if severe or systemic symptoms medical emergency, especially in young infants
- systemic treatment with acyclovir or valacyclovir[3]
- no systemic symptoms
- oral acyclovir or valacyclovir[3]
More general terms
Additional terms
References
- ↑ Ferri's Clinical Advisor, Instant Diagnosis and Treatment, Ferri FF (ed), Mosby, Philadelphia, 2003
- ↑ Jump up to: 2.0 2.1 Micali G, Lacarrubba F. (images) Eczema Herpeticum. N Engl J Med 2017; 377:e9. August 17, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28813215 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMicm1701668
- ↑ Jump up to: 3.0 3.1 3.2 3.3 NEJM Knowledge+ Dermatology
Traidl S, Roesner L, Zeitvogel J, Werfel T. Eczema herpeticum in atopic dermatitis. Allergy. 2021 Oct;76(10):3017-3027. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33844308 Review.