Abstract
EH is a vesicular eruption due to herpes simplex virus (HSV) occurring in children with atopic dermatitis. Mortality rates of 1-9 % have been reported. We studied clinical and epidemiologic features of the disease in 14 consecutive patients over a three year period. The mean age was 34 months (range 9 mo - 10½ yrs), 12 patients wereo < 3 yrs, 7 were male. Nine of 14 patients were febrile (≥ 38.5°C), 3 were hypo-albuminemic, 3 had elevated liver enzymes, 2 hyponatremic dehydration, 2 thrombocytopenia, 1 acidosis. HSV was cultured from all patients; a rapid viral diagnosis was made in 8 patients (72 %) following examination of vesicle fluid with electron microscopy; a significant rise in complement fixation titers to HSV in 7/7 patients. Staph. Aureus was cultured from skin lesions in 11/14 (77 %), B-hemolytic strep. group A in 4 (28%), pseudomonas in 2 (four patients had more than 1 pathogen isolated). There was a family history of “cold sores” occurring in one or other parent in the previous week in 5 of 14 children (35%); autoinnoculation may have been the mode of spread in 2 children (1 had herpes labialis initially, the other an herpetic whitlow). In four children (28%), parents had been increasing the amount and frequency of steroid cream application due to what was thought to be a flare-up of the eczema. These children all had widespread lesions on admission. Patients were treated with Acyclovir (I.V or oral), a penicillinase-resistant antibiotic, antipruritics and fresh frozen plasma when indicated. Parents need to be warned of the potential hazards that herpes super-infection may pose to their children with eczema.
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Novelli, V., Atterton, D. ECZEMA HERPETICUM (EH): CLINICAL AND EPIDEMIOLOGIC FEATURES. Pediatr Res 21 (Suppl 4), 260 (1987). https://doi.org/10.1203/00006450-198704010-00560
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DOI: https://doi.org/10.1203/00006450-198704010-00560