Synonym: eczema herpeticum
Clinical features:
(1) generalized asynchronous vesiculobullous eruption with macules, papules, vesicles and crusted lesions
(2) can affect patients of any age but more common in children
(3) demonstration of Herpes simplex virus (HSV)
(4) may disseminate to involve internal organs
(5) high mortality if untreated
Risk factors:
(1) eczema
(2) second degree skin burns
(3) rosacea
(4) pemphigus
(5) keratosis follicularis
(6) dermabrasion
(7) mycosis fungoides
(8) Sezary syndrome
(9) pregnancy
(10) skin graft
(11) topical tacrolimus or other drugs suppressing cell-mediated immunity
(12) any condition that disrupts skin integrity
Differential diagnosis:
(1) Coxsackie A16 (hand-foot-mouth syndrome)
(2) primary varicella
(3) disseminated herpes zoster
(4) monkey pox
Therapy may involve intravenous acyclovir or oral valacyclovir.
