ECZEMA HERPETICUM

Eczema Herpeticum (EH) is the superinfection of eczematous skin by the herpes simplex virus.  

• AKA Kaposi varicelliform eruption, EH most commonly occurs with eczema, but may also bee seen in Darier disease, ichthyosis vulgaris, burns, irritant contact dermatitis, seborrheic dermatitis and psoriasis.
• A high percentage of patients with eczema herpeticum have herpes simplex DNA in their mouth (as detected by PCR), suggesting that possibly oral shedding or undiagnosed oral herpetic lesion can trigger the eczema herpeticum.

Clinical

Rapidly progressive, widespread crusted papules, vesicles and erosions in a child with atopic dermatitis is characteristic.

Potential Complications

Secondary bacterial infections, herpetic keratitis, and in severe cases, systemic infection with potential organ failure or death are potential complications of EH.

Differential Diagnosis

Many patients with atopic dermatitis will present with crusted lesions and the etiology--viral vs. staphylococcus--is impossible to determine without a culture. Thus, both viral and bacterial cultures are essential when vesicles are not apparent.

RegionalDerm

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