Eczema Herpeticum

Eczema herpeticum
Other names: Kaposi varicelliform eruption, pustulosis varioliformis acute, Kaposi-Juliusberg dermatitis
Specialty	Dermatology
Complications	Secondary bacterial infection, blindness[1][2]
Duration	Up to six weeks
Causes	Herpes simplex virus (HSV) type 1 or 2[1]
Risk factors	Atopic dermatitis (eczema), other forms of dermatitis, burns, ichthyoses[2]
Diagnostic method	Based on symptoms, confirmed by testing[1]
Differential diagnosis	Impetigo, hand-foot-and-mouth disease, disseminated herpes zoster, disseminated molluscum contagiosum, dermatitis herpetiformis, eczema vaccinatum[2]
Treatment	Acyclovir, valacyclovir, supportive care[2]
Frequency	Rare[3]

Eczema herpeticum is a widespread viral infection associated with small skin blisters.^[1][2] The blisters generally begin in groups at the site of other skin problems and are painful.^[2] They then break open to form small ulcers before developing a blood-stained crust.^[2] Associated symptoms often include fever and swollen lymph nodes.^[2] Healing generally occurs within six weeks.^[2] Complications may include secondary bacterial infection and blindness.^[1][2]

It is most commonly caused by a first episode of herpes simplex virus (HSV) type 1 or 2.^[1] Those affected generally have atopic dermatitis (eczema); though it may also occur in other skin conditions such as other forms of dermatitis, burns, and ichthyoses.^[2] Diagnosis is generally based on symptoms and may be confirmed by viral culture or PCR.^[1] Coxsackievirus A16 or vaccinia virus (eczema vaccinatum) may produce a similar condition.^[1]

Treatment should occur promptly with either acyclovir or valacyclovir.^[2] Supportive care, including intravenous fluids, nutritional support, and pain medication may also be required.^[2] Death is rare with appropriate treatment.^[1][2] Some; however, are left with permanent loss of function.^[2]

Eczema herpeticum affects about 3% of people with atopic dermatitis.^[3] Children are more commonly affected than adults.^[2] It was first described in 1887 by Moritz Kaposi.^[1][3] Some use the term "eczema herpeticum" when it occurs in atopic dermatitis and "Kaposi varicelliform eruption" when it occurs in other skin conditions.^[1]

Signs and symptoms[edit | edit source]

In addition to the skin, this infection affects multiple organs, including the eyes, brain, lung, and liver, and can be fatal.

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Treatment[edit | edit source]

It can be treated with systemic antiviral drugs, such as aciclovir or valganciclovir.^[4] Foscarnet may also be used for immunocompromised host with Herpes simplex and acyclovir-resistant Herpes simplex.

History[edit | edit source]

Eczema herpeticum was first described by Hungarian dermatologist Moriz Kaposi in 1887.^[5] Fritz Juliusberg coined the term Pustulosis varioliformis acute in 1898.

Epidemiology[edit | edit source]

Even though the disease may develop at any age it is mostly present in childhood.^[6] Those who are affected typically had pre-existing cutaneous condition like atopic dermatitis.^[6]

See also[edit | edit source]

• List of cutaneous conditions

References[edit | edit source]

External links[edit | edit source]

Classification	ICD-10: B00.0 ICD-9-CM: 054.0 MeSH: D007617 DiseasesDB: 31391 SNOMED CT: 186535001
External resources	eMedicine: article/1132622

• Eczema Herpeticum photo library at Dermnet Archived 2009-06-09 at the Wayback Machine