Eczema herpeticatum

Abstract

Patients affected by atopic dermatitis tend to develop viral infections. Probably the most feared complication of atopic dermatitis is eczema herpeticum, a disseminated infection with herpes simplex virus. A monomorphic eruption of dome-shaped blisters, pustules and erosions in the eczematous skin lesions along with severe systemic illness leads to the diagnosis. The clinical diagnosis may be confirmed by polymerase chain reaction, viral culture, electron microscopy with negative staining, Tzanck test, immunofluorescence tests or serology. While intravenous acyclovir is still regarded as standard treatment of eczema herpeticum, several recently-developed antiviral drugs provide therapeutic options.

Phenotype of atopic dermatitis subjects with a history of eczema herpeticum

“…Fortunately, cases of EV have occurred only rarely since the risk of vaccinating high-risk subjects was appreciated. However, 7 to 10% of AD subjects have difficulty containing other cutaneous viral infections caused by herpes simplex virus (HSV) and molluscum contagiosum virus (MCV) 1. The most commonly recognized viral complication in AD subjects is eczema herpeticum (EH) caused by an extensive cutaneous infection with HSV.…”

Comparative proteomic profiling of patients with atopic dermatitis based on history of eczema herpeticum infection and Staphylococcus aureus colonization

“…Numerous factors modulate disease severity on an individual basis, including genetic susceptibility,4 immune response,5 and diverse environmental factors 3. AD patients are prone to skin infections, including eczema herpeticum (EH), a disseminated herpes simplex virus (HSV)-1 or -2 infection that occurs in a subset of AD patients 6. EH can be complicated by keratoconjunctivitis, viremia, meningitis and encephalitis 7.…”

Atopic Dermatitis Host and Environment Model: Revisiting Therapeutic Options

“…Besides pathogenic bacteria, other causes of infections in AD patients are virus and fungi. Herpes simplex virus (HSV) can lead to the disseminated HSV infection eczema herpeticatum, probably the most feared complication of AD (53). In addition, Malassezia yeast species colonize the skin of 90% of AD patients compared with 35% of healthy controls, especially the sebaceous areas of the face, scalp and upper body.…”