Eczema Herpeticum Flashcards
What is eczema herpeticum?
Eczema herpeticum is a viral skin infection caused by the herpes simplex virus (HSV) or varicella zoster virus (VZV).
What is the most common causing organism of eczema herpeticum?
Herpes simplex virus 1 (HSV-1) is the most common causative organism, and may be associated with a coldsore in the patient or a close contact. It usually occurs in a patient with a pre-existing skin condition, such as atopic eczema or dermatitis, where the virus is able to enter the skin and cause an infection.
What are the clinical features of eczema herpeticum?
A typical presentation is a patient who suffers with eczema that has developed a widespread, painful, vesicular rash with systemic symptoms such as fever, lethargy, irritability and reduced oral intake. There will usually be lymphadenopathy (swollen lymph nodes).
Briefly describe the rash of eczema herpeticum
The rash is usually widespread and can affect any area of the body. It is erythematous, painful and sometimes itchy, with vesicles containing pus. The vesicles appear as lots of individual spots containing fluid. After they burst, they leave small punched-out ulcers with a red base.
How is eczema herpeticum diagnosed?
Viral swabs of the vesicles can be used to confirm the diagnosis, although treatment is usually started based on the clinical appearance.
Briefly describe the treatment of eczema herpeticum
Treatment is with aciclovir. A mild or moderate case may be treated with oral aciclovir, whereas more severe cases may require IV aciclovir.
What are the complications of eczema herpeticum?
Children with eczema herpeticum can be very unwell. When not treated adequately it can be a life threatening condition, particularly in patients that are immunocompromised.
Bacterial superinfection can occur, leading to a more severe illness. This needs treatment with antibiotics.
