Eczema Herpeticum

Author: Kawaroreet Karwal MS2, Y, Miller-Monthrope, Dermatologist/Dermatopathologist, Toronto, Canada, 2024

Definition: Eczema herpeticum (also known as Kaposi varicelliform eruption) is a severe, potentially life-threatening skin infection caused by the herpes simplex virus (HSV) in individuals with atopic dermatitis or other underlying skin conditions. 

Epidemiology: It typically occurs in children and young adults but can affect individuals of any age. 

Symptoms: Eczema herpeticum usually presents with clusters of painful, monomorphic, punched-out erosions that rapidly spread over eczematous skin areas. The affected areas may become swollen, and the lesions can develop into pustules, vesicles, and crusts. Systemic symptoms such as fever, malaise, and lymphadenopathy may also be present. 

Diagnosis: Early diagnosis and treatment are crucial to prevent complications. Antiviral medications, such as acyclovir or valacyclovir, are the primary treatment options and should be administered promptly. In severe cases, hospitalization may be required for intravenous antiviral therapy and supportive care. Corticosteroids and antibiotics may be used to manage concurrent inflammation and bacterial infections.

References:

1.     Eichenfield, L. F., Tom, W. L., Chamlin, S. L., Feldman, S. R., Hanifin, J. M., Simpson, E. L., & Paller, A. S. (2014). Guidelines of care for the management of atopic dermatitis. Journal of the American Academy of Dermatology, 71(1), 116-132.

2.     Wollenberg, A., Oranje, A., Deleuran, M., Simon, D., Szalai, Z., Kunz, B., … & Taïeb, A. (2016). ETFAD/EADV eczema task force position paper on diagnosis and treatment of atopic dermatitis. Journal of the European Academy of Dermatology and Venereology, 30(5), 729-747.

3.     Hebert, A. A., & Rodriguez, L. A. (2016). Management of eczema herpeticum in children. Pediatric Dermatology, 33(4), 357-361.