View source for Eczema herpeticum

==Background==
*Diffuse [[HSV]] infection occurring in 3% of patients patients with [[atopic dermatitis]]<ref>Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.</ref>
*May be life-threatening

==Clinical Features==
[[File:Eczema Herpeticum picture.png|thumb|Eczema Herpeticum in immunocompromised patient.<ref>Bagazgoitia L, Beà S, Garate M, Moreno R, Jaén P. ECZEMA HERPETICUM IN A PATIENT WITH TERMINAL RENAL FAILURE UNDER NARROW-BAND UVB THERAPY. Indian Journal of Dermatology. 2010;55(2):200-201. doi:10.4103/0019-5154.62744.</ref>).]]
[[File: Eczema_Herpticum_picutre_2.jpg|thumb|Eczema herpticum in child.<ref>Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.</ref>]]
*Development of vesicular eruptions containing HSV 1 or 2 in areas of epidermis previously affected by atopic dermatitis
*Lesions may appear similar to impetigo<ref>Liaw F-Y, Huang C-F, Hsueh J-T, Chiang C-P. Eczema herpeticum: A medical emergency. Canadian Family Physician. 2012;58(12):1358-1361.</ref>
*[[Fever]] is common
*Multiple organ systems can become involved, resulting in [[lymphadenopathy]], [[keratoconjunctivitis]] (potentially sight-threatening),[[meningitis]], [[encephalitis]], etc <ref>Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.</ref>.
*Lesions may become secondarily infected by bacteria, mainly with staph aureus<ref>Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.</ref>.    
*The following is associated with increased susceptibility to Eczema Herpeticum<ref>Bagazgoitia L, Beà S, Garate M, Moreno R, Jaén P. ECZEMA HERPETICUM IN A PATIENT WITH TERMINAL RENAL FAILURE UNDER NARROW-BAND UVB THERAPY. Indian Journal of Dermatology. 2010;55(2):200-201. doi:10.4103/0019-5154.62744.</ref>:
**Early age of onset of eczema
**History of food allergies or asthma<ref>Leung DYM. Why is eczema herpeticum unexpectedly rare? Antiviral research. 2013;98(2):153-157. doi:10.1016/j.antiviral.2013.02.010.</ref>
**Larger surface area of eczema
**Eczema of the head/neck
**Increased levels of IgE

==Differential Diagnosis==
*[[Impetigo]]
*Eczema Vaccinatum
*Primary [[varicella]] infection

{{HSV-1 DDX}}

==Evaluation<ref>Liaw F-Y, Huang C-F, Hsueh J-T, Chiang C-P. Eczema herpeticum: A medical emergency. Canadian Family Physician. 2012;58(12):1358-1361.</ref>==
*Clinical
*Viral culture from swabs of wounds
*Tzanck smears showing multi-nucleated giant cells 
*Direct Fluorescence antigen test for HSV

==Management==
*Treatment to cover [[Staph]] and [[Strep]]
*[[Bactrim]] 10mg/kg/d in 2 divided doses '''OR''' [[clindamycin]] 24mg/kg/d divided into 3 doses x10d
*[[Acyclovir]] 80mg/kg/d in 3 divided doses x10<ref>Aronson PL, Yan AC, Mittal MK, Mohamad Z, Shah SS. Delayed Acyclovir and Outcomes of Children Hospitalized With Eczema Herpeticum. Pediatrics. 2011;128(6):1161-1167. doi:10.1542/peds.2011-0948.</ref>

==Disposition==

==See Also==
*[[HSV]]

==External Links==

==References==
<references/>

[[Category:Dermatology]]
[[Category:ID]]