Eczema herpeticum

A viral infection of the skin associated with eczema

Eczema herpeticum, also known as Kaposi varicelliform eruption, is a skin infection caused by the herpes simplex virus (HSV) in individuals with pre-existing atopic dermatitis or other forms of eczema. This condition is characterized by the rapid spread of painful, vesicular lesions over the affected areas of skin.

Pathophysiology

Eczema herpeticum occurs when the herpes simplex virus infects the compromised skin barrier of individuals with eczema. The virus can spread rapidly, leading to widespread skin lesions. The condition is most commonly caused by HSV-1, although HSV-2 can also be responsible.

Clinical Presentation

Lesions of eczema herpeticum on the face

Patients with eczema herpeticum typically present with clusters of small, fluid-filled blisters that can become painful and crusted. These lesions often appear on areas of skin affected by eczema but can spread to other parts of the body. Systemic symptoms such as fever, malaise, and lymphadenopathy may also be present.

Diagnosis

The diagnosis of eczema herpeticum is primarily clinical, based on the appearance of the characteristic vesicular lesions in a patient with a history of eczema. Confirmation can be obtained through laboratory tests such as viral culture, polymerase chain reaction (PCR), or direct fluorescent antibody testing.

Treatment

The mainstay of treatment for eczema herpeticum is antiviral therapy. Acyclovir is commonly used to treat the infection and should be initiated promptly to reduce the risk of complications. Supportive care, including pain management and maintaining skin hydration, is also important.

Complications

If left untreated, eczema herpeticum can lead to serious complications such as bacterial superinfection, keratoconjunctivitis if the eyes are involved, and in rare cases, systemic dissemination of the virus.

Prevention

Preventive measures include managing underlying eczema effectively to maintain skin barrier integrity and avoiding contact with individuals known to have active herpes simplex infections.

Related pages

• Atopic dermatitis
• Herpes simplex
• Viral skin infections