Abstract
We present 5 cases of eczema herpeticum in patients with severe recalcitrant atopic dermatitis to illustrate the range of possible clinical findings and supporting laboratory data that can obscure the diagnosis and complicate treatment. Major issues include: the need for aggressive laboratory evaluation (molecular diagnostics, viral cultures, skin biopsy, serology); the possibility of recurrent or chronic infection; the value of empiric antiviral therapy; the possibility of infection with thymidine-kinase resistant strains; and the importance of achieving control over the dermatitis with nonmyelosuppressive immunomodulating agents such as intravenous immunoglobulin or interferon gamma for dermatitis that requires systemic treatment.
© 2011 Wiley Periodicals, Inc.
MeSH terms
-
2-Aminopurine / analogs & derivatives
-
2-Aminopurine / therapeutic use
-
Acyclovir / therapeutic use
-
Adolescent
-
Antiviral Agents / therapeutic use
-
Child
-
Child, Preschool
-
Dermatitis, Atopic / diagnosis*
-
Dermatitis, Atopic / drug therapy
-
Dermatitis, Atopic / virology
-
Famciclovir
-
Female
-
Herpes Simplex / diagnosis
-
Herpes Simplex / drug therapy
-
Humans
-
Immunoglobulins, Intravenous / therapeutic use
-
Interferon-gamma / therapeutic use
-
Kaposi Varicelliform Eruption / diagnosis*
-
Kaposi Varicelliform Eruption / drug therapy
-
Kaposi Varicelliform Eruption / virology
-
Male
-
Methotrexate / therapeutic use
-
Patch Tests
-
Severity of Illness Index
-
Treatment Outcome
Substances
-
Antiviral Agents
-
Immunoglobulins, Intravenous
-
2-Aminopurine
-
Interferon-gamma
-
Famciclovir
-
Acyclovir
-
Methotrexate