Herpeticum-like rash in a child with atopic dermatitis: early clinical suspicion is valuable

Γώγου, Μαρία; Douma, Stergianna; Haidopoulou, Katerina; Giannopoulos, Andreas A.

doi:10.24911/sjp.106-1536167231

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…The initial manifestation of the condition predominantly occurs in children, while the recurrent form is more prevalent among older individuals. Despite AD being the most prominent risk factor, EH may coexist with various other skin conditions, including but not limited to ichthyosis vulgaris, bullous pemphigoid, dyskeratosis follicularis, mycosis fungoides, and contact dermatitis [12]. The compromised skin barrier observed in AD could potentially facilitate virus entry.…”

Section: Discussionmentioning

confidence: 99%

“…Before the introduction of acyclovir, the mortality rate associated with EH stood at 50% [2,15]. Furthermore, complications of this condition can include meningoencephalitis, keratoconjunctivitis, and disseminated intravascular coagulation [12]. Given the significant risk of ocular disease problems, ophthalmology observation should be considered, especially if there are periocular lesions or ocular symptoms [16].…”

Section: Discussionmentioning

confidence: 99%

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Eczema Herpeticum Complicating Atopic Dermatitis: A Rare Presentation

Pedro,

Caldas,

Neves

et al. 2024

Cureus

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Atopic dermatitis (AD) has become a global health concern due to an increase in its frequency over the past few decades. This illness not only reduces the quality of life but also imposes a considerable financial burden due to the increased risk of skin infections. This case report explores the presentation of a four-month-old male infant with a personal history of atopic dermatitis that developed yellow scaly lesions on the scalp, which were assumed to be cradle cap. However, there was a clinical worsening of the cutaneous lesions, with the appearance of vesicles, so he was referred to the Pediatric Emergency Room after an urgent dermatology appointment. A blood test was performed, which revealed severe eosinophilia and a slightly increased total IgE. Considering the patient's past medical record of atopic dermatitis and the observable characteristics of the skin rash, there was a strong suspicion of eczema herpeticum (EH). Consequently, intravenous acyclovir treatment was initiated, along with an antibiotic, as there were concerns about a potential secondary infection. He was followed up with a pediatric and dermatology appointment, with a resolution of skin lesions after six weeks.EH is a rare clinical entity, usually caused by herpes simplex virus (HSV) types 1 and 2. It is a clinical entity that, while being uncommon, is one of the few dermatological emergencies responsible for a high morbidity rate, associated with the systemic spread of the viral infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Eczema Herpeticum Complicating Atopic Dermatitis: A Rare Presentation

Pedro,

Caldas,

Neves

et al. 2024

Cureus

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“…In some cases, it may progress to fulminating, life-threatening infection and can have severe sequelae [10]. Although it commonly appears on a background of atopic dermatitis (AD), it has been described in association with other skin conditions such as ichthyosis vulgaris, bullous pemphigoid, dyskeratosis follicularis (Darier disease), mycosis fungoides, and contact dermatitis [11, 12]. The association with AcE, to the best of our knowledge, has not yet been described.…”

Section: Introductionmentioning

confidence: 99%

Concurrence of Acrodermatitis Enteropathica and Eczema Herpeticum in a Child with Atopic Dermatitis

et al. 2019

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Acrodermatitis enteropathica (AcE) is a rare, autosomal recessive inherited disorder caused by mutation of the SLC39A4 gene coding for zinc transport protein (ZIP 4). The disease appears during childhood especially in breastfeeding or post-breastfeeding infant. Eczema herpeticum refers to a disseminated skin infection of herpes simplex virus that usually leads to vesicular eruptions commonly seen on a background of atopic dermatitis (AD). We describe an 11-year-old boy with periorificial erosions in periorbital, perinasal, perioral, perineal, and gluteal areas, accompanied with itchy vesicles, some covered with hemorrhagic crusts. A clinical diagnosis of AcE and eczema herpeticum with AD was supported by typical lesions and acute and chronic eczematous changes found mainly in the flexural aspects of extremities, which is diagnostic of AD. Laboratory findings showed anti HSV1 IgG (23.43) and high levels of IgE (478.9 IU/L). There was no multinucleated giant cell in the Tzanck test. Skin histology was compatible with AcE. Direct immunofluorescent examination showed no deposits of IgG, IgM, IgA, or complement. Complete resolution occurred within 2 weeks of acyclovir and oral zinc supplementation.

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