Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

View all Images (45)

Potentially life-threatening emergency
Eczema herpeticum in Infant/Neonate
Other Resources UpToDate PubMed
Potentially life-threatening emergency

Eczema herpeticum in Infant/Neonate

Contributors: Elizabeth B. Wallace MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Eczema herpeticum, or Kaposi varicelliform eruption, is a superficial, widespread cutaneous infection with herpes simplex virus (HSV) 1 or 2 in a patient with preexisting skin disease. The herpes infection may be primary and sustained from a close contact, or it may occur via autoinoculation. Vesicles, pustules, and characteristic "punched-out" erosions with hemorrhagic crust are superimposed on areas of preexisting skin disease. Presentation ranges from mild and transient to life-threatening.

Eczema herpeticum is more commonly seen in patients with atopic dermatitis but may also be seen in cases of Darier disease, autoimmune bullous dermatoses, burns, mycosis fungoides, pityriasis rubra pilaris, and other forms of dermatitis such as irritant contact and seborrheic dermatitis. It mostly affects children but can occur in any age group.

Risk factors that have been proposed for the development of eczema herpeticum include mutations in filaggrin and deficiency of cathelicidins, skin antimicrobial peptides, in the skin.

Patients can develop numerous vesicles that may appear in crops for several days. Associated systemic symptoms can include high fevers, lymphadenopathy, and malaise. The primary infection is usually more severe than recurrent episodes.

Complications of eczema herpeticum include secondary bacterial infection and multi-organ involvement, including keratoconjunctivitis, meningitis, and encephalitis. Commonly implicated pathogens in bacterial superinfection include Staphylococcus aureus or Streptococcus pyogenes. Systemic viremia can result in serious morbidity and mortality, especially in infants.

Eczema herpeticum is rare during the neonatal period. If HSV infection develops during the first week of life, the diagnosis of neonatal herpes simplex virus should be considered. Eczema herpeticum is a medical emergency in neonates, infants, and children, and early treatment with antiviral therapy is required.

Codes

ICD10CM:
B00.0 – Eczema herpeticum

SNOMEDCT:
186535001 – Eczema herpeticum

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Reviewed:03/02/2017
Last Updated:02/04/2021
Copyright © 2023 VisualDx®. All rights reserved.
Potentially life-threatening emergency
Eczema herpeticum in Infant/Neonate
A medical illustration showing key findings of Eczema herpeticum : Fever, Malaise, Umbilicated vesicles
Clinical image of Eczema herpeticum - imageId=270255. Click to open in gallery.  caption: 'A close-up of many discrete and confluent, monomorphic crusts and a few outlying vesicles.'
A close-up of many discrete and confluent, monomorphic crusts and a few outlying vesicles.
Copyright © 2023 VisualDx®. All rights reserved.