Localized herpes simplex infections in atopic dermatitis

Abstract

Herpes simplex infections, localized to areas of atopic dermatitis, were documented in ten children. The typical clinical picture consisted of low-grade fever and exacerbation of the eczema with discrete vesicles localized to affected skin, followed by punched-out ulcerations. Recurrent attacks were observed in seven cases and coincided with active attacks of herpes labialis in other family members or close friends, suggesting reinfection as the source. In no patient did a disseminated Kaposi's varicelliform type of eruption develop. Viral cultures in 30 additional patients with acute flares of atopic dermatitis without vesicles or ulcerations failed to disclose any herpes simplex.

Clinical Epidemiology of Symptomatic Primary Herpetic Infection in Children

“…Infants with atopic dermatitis experience a more severe PHI during their first year of life (5 patients in our series). Among 10 atopic children of more than 3 years, PHI was associated with mild disease (20). The immaturity of the immunological status in younger patients as ours may explain why they are more prone to severe PHI.…”

The role of bacterial skin infections in atopic dermatitis: expert statement and review from the International Eczema Council Skin Infection Group

“…Several nonbacterial infections can occur concomitantly with bacterial skin infection and can resemble bacterial infections, requiring consideration in the differential diagnosis. For instance, eczema herpeticum (EH) is caused by the local spread of herpes simplex virus, which favours AD lesional skin and is commonly observed in the context of an AD flare . Early in the course of EH the characteristic skin lesions are superficial clusters of dome‐shaped vesicles and/or small, round, punched‐out erosions (Fig.…”

“…Early in the course of EH the characteristic skin lesions are superficial clusters of dome‐shaped vesicles and/or small, round, punched‐out erosions (Fig. a, b) . As the disease progresses, lesions may become superficially infected with S. aureus and may develop an impetiginized scale (Fig.…”

Pathogenesis of eczema

“…Verruca vulgaris (common warts). Molluscum contagio-.sum, and rarely Vaccinia [24,25], decreased ability to be sensitized to Rhus (poison ivy) and dinitrochlorobenzene [26], decreased lymphocyte response to mitogens. recall antigens, and allo-antigens in vitro [27,28], defective generation of cytotoxic T lymphocyte response in vitro [29].…”