Eczema herpeticum
Background
- Diffuse HSV infection occurring in 3% of patients patients with atopic dermatitis[1]
- May be life-threatening
Clinical Features
Eczema Herpeticum in immunocompromised patient.[2]).
Eczema herpticum in child.[3]
- Development of vesicular eruptions containing HSV 1 or 2 in areas of epidermis previously affected by atopic dermatitis
- Lesions may appear similar to impetigo[4]
- Fever is common
- Multiple organ systems can become involved, resulting in lymphadenopathy, keratoconjunctivitis (potentially sight-threatening),meningitis, encephalitis, etc [5].
- Lesions may become secondarily infected by bacteria, mainly with staph aureus[6].
- The following is associated with increased susceptibility to Eczema Herpeticum[7]:
- Early age of onset of eczema
- History of food allergies or asthma[8]
- Larger surface area of eczema
- Eczema of the head/neck
- Increased levels of IgE
Differential Diagnosis
Herpes Simplex Virus-1
- Eczema herpeticum
- Herpes gingivostomatitis
- Herpes keratitis
- Herpes labialis (cold sore)
- Herpes simplex encephalitis
- Herpetic whitlow
- Impetigo
- Eczema Vaccinatum
- Primary varicella infection
Evaluation[9]
- Clinical
- Viral culture from swabs of wounds
- Tzanck smears showing multi-nucleated giant cells
- Direct Fluorescence antigen test for HSV
Management
- Treatment to cover Staph and Strep
- Bactrim 10mg/kg/d in 2 divided doses OR clindamycin 24mg/kg/d divided into 3 doses x10d
- Acyclovir 80mg/kg/d in 3 divided doses x10[10]
Disposition
See Also
External Links
References
- ↑ Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.
- ↑ Bagazgoitia L, Beà S, Garate M, Moreno R, Jaén P. ECZEMA HERPETICUM IN A PATIENT WITH TERMINAL RENAL FAILURE UNDER NARROW-BAND UVB THERAPY. Indian Journal of Dermatology. 2010;55(2):200-201. doi:10.4103/0019-5154.62744.
- ↑ Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.
- ↑ Liaw F-Y, Huang C-F, Hsueh J-T, Chiang C-P. Eczema herpeticum: A medical emergency. Canadian Family Physician. 2012;58(12):1358-1361.
- ↑ Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.
- ↑ Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.
- ↑ Bagazgoitia L, Beà S, Garate M, Moreno R, Jaén P. ECZEMA HERPETICUM IN A PATIENT WITH TERMINAL RENAL FAILURE UNDER NARROW-BAND UVB THERAPY. Indian Journal of Dermatology. 2010;55(2):200-201. doi:10.4103/0019-5154.62744.
- ↑ Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.
- ↑ Liaw F-Y, Huang C-F, Hsueh J-T, Chiang C-P. Eczema herpeticum: A medical emergency. Canadian Family Physician. 2012;58(12):1358-1361.
- ↑ Aronson PL, Yan AC, Mittal MK, Mohamad Z, Shah SS. Delayed Acyclovir and Outcomes of Children Hospitalized With Eczema Herpeticum. Pediatrics. 2011;128(6):1161-1167. doi:10.1542/peds.2011-0948.