Morán VE, Maldonado CG, López CYI, Saéz-de Ocariz M, Orozco CL, Duran MC, Palacios LC, Ruiz MR

Language: Spanish
References: 16
Page: 86-90
PDF size: 233.26 Kb.

ABSTRACT

Eczema herpeticum is an acute dermatosis, caused by the cutaneous dissemination of herpes simplex virus in patients with atopic dermatitis and other skin diseases. It constitutes a dermatologic emergency and a potential life-threatening complication in these patients. Clinically, patients present with a disseminated vesicular eruption which progresses to crusts that cover punch-like erosions. The diagnosis is clinical, but it can be confirmed by laboratory work-up. The antiviral therapy with nucleoside analogues, has reduced mortality from 75% to less than 10%. We discuss the case of a 15-year-old female patient with atopic dermatitis, who presented a facial vesiculopapular rash with malaise and fever. The lesions spread to the neck, arms and chest, and evolved into crusts and erosions. Eczema herpeticum was diagnosed and timely managed with acyclovir (1,500 mg/m²bs/day) and dicloxacillin (100 mg/kg/day) due to secondary impetigo. The patient was sent home without sequelae.

REFERENCES

1. Wollenberg A, Wetzel S, Burgdorf WH, Haas J. Viral infections in atopic dermatitis: Pathogenic aspects and clinical management. J Allergy Clin Immunol. 2003; 112 (4): 667-674.

2. Schroeder HF, Elgueta NA, Martínez GMJ. Eccema herpético por virus herpes simplex tipo 2. Revisión de la literatura a propósito de un caso. Rev Chil Infect. 2009; 26 (4): 3356-3359.

3. Vogt KA, Lohse CM, El-Azhary RA, Gibson LE, Lehman JS. Kaposi varicelliform eruption in patients with Darier disease: A 20-year retrospective study. J Am Acad Dermatol. 2015; 72 (3): 481-484.

4. Kucukyilmaz I, Alpsoy E, Yazar S. Kaposi’s varicelliform eruption in association with rosacea. J Am Acad Dermatol. 2004; 51 (5): S169-S172.

5. Kosann MK, Fogelman JP, Stern RL. Kaposi’s varicelliform eruption in a patient with Grover’s disease. J Am Acad Dermatol. 2003; 49 (5): 914-915.

6. Champet-Lima AM, Llergo-Valdez RJ, Ramón-García G, Velásquez-González E. Eccema herpético. Una urgencia dermatológica real. Comunicación de un caso. Dermatol Rev Mex. 2010; 54 (3): 141-144.

7. Wollenberg A, Zoch C, Wetzel S, Plewing G, Przybilla B. Predisposing factors and clinical features of eczema herpeticum: a retrospective analysis of 100 cases. J Am Acad Dermatol. 2003; 49 (2): 198-205.

8. Bedolla BM, Barrera ZAT, Morales RJ. Dermatitis atópica en niños escolares de Ciudad Guzmán, México. Prevalencia y factores asociados. Rev Alergia Mex. 2010; 57 (3): 71-78.

9. Luca NJ, Lara-Corrales I, Pope E. Eczema herpeticum: clinical features and factors predictive of hospitalization. J Pediatr. 2012; 161 (4): 671-675.

10. Leung DY. Why is eczema herpeticum unexpectedly rare? Antiviral Res. 2013; 98 (2): 153-157.

11. Beck LA, Boguniewicz M, Hata T, Schneider LC, Hanifin J, Gallo R et al. Phenotype of atopic dermatitis subjects with a history of eczema herpeticum. J Allergy Clin Immunol. 2009; 124 (2): 260-269.

12. Aronson PL, Yan AC, Mittal MK, Mohamad Z, Shah SS. Delayed aciclovir and outcomes of children hospitalized with eczema herpeticum. Pediatrics. 2011; 128 (6): 1161-1167.

13. Frisch S, Siegfried EC. The clinical spectrum and therapeutic challenge of eczema herpeticum. Pediatr Dermatol. 2011; 28 (1): 46-52.

14. Aronson PL, Shah SS, Mohamad Z, Yan AC. Topical corticosteroids and hospital length of stay in children with eczema herpeticum. Pediatric Dermatol. 2013; 30 (2): 215-221.

15. Studdiford JS, Valko GP, Belin LJ, Stonehouse AR. Eczema herpeticum: making the diagnosis in the emergency department. J Emerg Med. 2011; 40 (2): 167-169.

16. Liaw FY, Huang CF, Hsueh JT, Chiang CP. Eczema herpeticum. A medical emergency. Can Fam Physician. 2012; 58 (12): 1358-1361.