acyclovir and Dermatitis--Atopic

The eponym Kaposi's varicelliform eruption (KVE) describes a characteristic syndrome of disseminated vesicopustules that occasionally complicates a number of dermatoses. Among these, the most common is atopic dermatitis, and the inciting agent is most often herpes simplex virus (HSV). Very few reports of ocular herpetic disease exist among the many cases of KVE reported in the literature, despite extensive cutaneous involvement with herpetic lesions. We describe 10 patients with KVE, none of whom have developed evidence of herpetic ocular disease despite widespread facial involvement in all patients. All random conjunctival swab cultures performed in 3 patients were positive for growth of viable HSV. Although ocular exposure to HSV may commonly occur in KVE, ocular pathology due to this virus does not appear to be a common sequela.

Topics: Acyclovir; Adult; Child; Child, Preschool; Darier Disease; Dermatitis, Atopic; Facial Dermatoses; Female; Follow-Up Studies; Humans; Infant; Kaposi Varicelliform Eruption; Keratitis, Dendritic; Male; Middle Aged

Topics: Acyclovir; Dermatitis, Atopic; Eczema; Humans; Janus Kinase 1; Janus Kinase Inhibitors

Topics: Acyclovir; Administration, Ophthalmic; Adult; Antiviral Agents; Dermatitis, Atopic; Female; Humans; Keratitis, Dendritic

Eczema herpeticum has been well described in the setting of atopic dermatitis (AD) and other dermatoses. We present the case of a 2-month-old infant boy with cutaneous herpes simplex virus (HSV) infection within existing diffuse infantile seborrheic dermatitis. Providers should be aware that cutaneous HSV can be confined to a seborrheic distribution and may represent underlying epidermal dysfunction secondary to seborrheic dermatitis.

Topics: Acyclovir; Antiviral Agents; Dermatitis, Atopic; Dermatitis, Seborrheic; Diagnosis, Differential; Humans; Infant; Infusions, Intravenous; Kaposi Varicelliform Eruption; Male; Scalp Dermatoses; Simplexvirus

Topics: Acyclovir; Administration, Oral; Antiviral Agents; Cefuroxime; Child, Preschool; Dermatitis, Atopic; Diagnosis, Differential; Drug Therapy, Combination; Female; Hand; Herpes Simplex; Herpesvirus 1, Human; Humans; Wrist

Eczema herpeticum is a dermatological emergency causing a mortality of up to 10% if untreated. It frequently presents in a localised form and rarely disseminates via haematogenous spread with pulmonary, hepatic, ocular and neurological manifestations. Although it commonly appears on a background of atopic dermatitis, many other dermatological conditions have been described preceding this disease. Eczema herpeticum can be easily mistaken for folliculitis and is often treated accordingly with antibacterial drugs; therefore patients will often deteriorate before a diagnosis of eczema herpeticum has been considered.

Topics: Acyclovir; Adult; Antiviral Agents; Dermatitis, Atopic; Diagnosis, Differential; Encephalitis, Viral; Folliculitis; Humans; Kaposi Varicelliform Eruption; Male

Topics: Acyclovir; Adult; Antiviral Agents; Dermatitis, Atopic; Female; Humans; Kaposi Varicelliform Eruption; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, First

Eczema coxsackium (EC) can manifest in patients with underlying atopic dermatitis (AD) as a diffuse vesicular rash in a febrile child. The presentation overlaps clinically with the feared diagnosis of eczema herpeticum (EH), which makes differentiating between the conditions very important.. A 6-month-old girl with known AD presented with fever and rapidly spreading vesicular rash. The patient had multiple exposures including a new antibiotic prescription, introduction of new foods, 6-month vaccinations and a sick contact. She was treated empirically with acyclovir for EH until herpes simplex virus (HSV) polymerase chain reaction (PCR) returned negative and enterovirus PCR returned positive. Once the diagnosis of EC was confirmed, antiviral therapy was discontinued and she was treated successfully with supportive measures without sequelae.. Differentiating EC from EH is important clinically as EC is self-limiting and resolves spontaneously whereas EH may cause severe complications if not treated early. While morphology alone cannot reliably distinguish between the conditions, clinical suspicion based on history can prompt proper testing and improve patient outcomes.

Topics: Acyclovir; Antiviral Agents; Dermatitis, Atopic; Disease Progression; Eczema; Female; Humans; Infant; Kaposi Varicelliform Eruption; Risk Factors; Simplexvirus

Topics: Acyclovir; Antiviral Agents; Child, Preschool; Dermatitis, Atopic; Drug Eruptions; Humans; Lichen Planus; Male; Skin

Eczema herpeticum is a rare and potentially life-threatening viral infection. We present the case of a 54-year-old man who presented to the emergency eye clinic with a dendritic ulcer and a facial rash. An initial diagnosis of herpes zoster ophthalmicus was suspected. On follow-up, the rash had begun to rapidly disseminate and was no longer respecting dermatome boundaries. A diagnosis of eczema herpeticum was made and appropriate treatment started. This case highlights the importance of a comprehensive history and close inspection of skin lesions in patients with herpetic eye disease.

Topics: Acyclovir; Antiviral Agents; Corneal Diseases; Dermatitis, Atopic; Diagnosis, Differential; Humans; Kaposi Varicelliform Eruption; Male; Middle Aged; Treatment Outcome

The field of pediatric dermatology has been rich in new developments. Part II of this continuing medical education article will focus on new therapeutic modalities for several entities encountered in pediatric dermatology. The treatment of atopic dermatitis, exciting advances in the use of propranolol and other beta-blockers for the use of infantile hemangiomas, the use of rapamycin for vascular anomalies, the use of biologics in children, the central nervous system risks of general anesthesia in young children, side effects in the use of isotretinoin, the treatment of tinea capitis, treatment of herpes simplex infections, and the use of technologies such as texting and social media in medicine will be discussed.

Topics: Acyclovir; Antiviral Agents; Dermatitis, Atopic; Dermatology; Hemangioma; Humans; Internet; Propranolol; Skin Diseases; Social Media; Tinea Capitis; Vascular Diseases; Vasodilator Agents

We present an unreported coexistence: eczema herpeticum (EH) with histopathological findings of herpetic folliculitis (HF) after allogeneic bone marrow transplantation (BMT). A patient with atopic dermatitis (AD) underwent allogeneic BMT for idiopathic acquired aplastic anemia. She had been receiving cyclosporine (150 mg/12 h) and acyclovir (400 mg/12 h) for 6 months. A facial rash was observed, composed of monotonous erythematous, umbilicated papulo-vesicles and papulo-crusts <4 mm in size. The histopathological study showed herpetic cytopathic changes within the epidermis that extended into the hair follicle epithelium. Interestingly, microscopic HF has not previously been associated with post-transplant patients or EH. However, it is reasonable to hypothesize that the coexistence of these herpes simplex virus-related events may be underreported in the literature. Although further studies are necessary, we suggest that the prophylactic antiviral dose after BMT be enhanced in patients with underlying dermatologic diseases, especially in those with AD.

Topics: Acyclovir; Adult; Anemia, Aplastic; Antiviral Agents; Bone Marrow Transplantation; Cyclosporine; Dermatitis, Atopic; Female; Folliculitis; Herpes Simplex; Herpesvirus 1, Human; Humans; Kaposi Varicelliform Eruption; Risk Factors

Topics: Acyclovir; Administration, Oral; Antiviral Agents; Dermatitis, Atopic; Humans; Immunoglobulin G; Kaposi Varicelliform Eruption; Male; Ointments; Recurrence; Treatment Outcome; Valacyclovir; Valine; Vidarabine; Young Adult

Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Antiviral Agents; Cyclosporine; Dermatitis, Atopic; Eczema; Herpes Simplex; Humans; Immunocompromised Host; Immunosuppressive Agents; Male; PUVA Therapy; Simplexvirus; Virus Activation

Topics: Acyclovir; Adrenal Cortex Hormones; Antiviral Agents; Dermatitis, Atopic; Diagnosis, Differential; Humans; Immunosuppressive Agents; Kaposi Varicelliform Eruption; Male; Middle Aged; Simplexvirus; Skin; Tacrolimus; Valacyclovir; Valine

Topics: Acyclovir; Adult; Antiviral Agents; Biopsy; Dermatitis, Atopic; Diagnosis, Differential; Exanthema; Facial Dermatoses; Herpesvirus 1, Human; Humans; Kaposi Varicelliform Eruption; Male; Skin; Social Stigma

Tacrolimus ointment 0.1 percent is a well-established topical therapy for treating atopic dermatitis. Efficacy and safety have been described in several trials. Here, we present a patient with rapid onset of extensive varicella zoster infection in tacrolimus-treated skin: a side effect that has only occasionally been reported. Early recognition is important because rapid treatment for herpes zoster may lead to less frequent post-herpetic neuralgia and serious complications.

Topics: Acyclovir; Antiviral Agents; Dermatitis, Atopic; Dermatologic Agents; Drug Therapy, Combination; Female; Fusidic Acid; Herpes Zoster; Herpesvirus 3, Human; Humans; Middle Aged; Ointments; Tacrolimus; Treatment Outcome; Valacyclovir; Valine

We report a case of eczema herpeticum with unilateral ocular involvement in a 16-year-old boy. The patient has had a mild form of atopic dermatitis (AD) since early childhood. Why AD patients are prone to herpes simplex virus (HSV) infections is still unclear. Ocular pathologic findings in these cases are rarely reported.

Topics: Acyclovir; Adolescent; Antiviral Agents; Conjunctivitis, Viral; Dermatitis, Atopic; Humans; Kaposi Varicelliform Eruption; Male; Treatment Outcome

Eczema herpeticum can clinically resemble smallpox. On the basis of the algorithm for rapid evaluation of patients with an acute generalized vesiculopustular rash illness, our patient met criteria for high risk for smallpox. The Tzanck preparation was critical for rapid diagnosis of herpetic infection and exclusion of smallpox.

Topics: Acyclovir; Animals; Antiviral Agents; Dermatitis, Atopic; Diagnosis, Differential; Herpesvirus 3, Human; Humans; Kaposi Varicelliform Eruption; Male; Middle Aged; Necrosis; Simplexvirus; Smallpox; Treatment Outcome

A 35-year-old woman with a history of atopic diathesis presented to the emergency department with 2 weeks of widespread facial vesiculopustules and eroded vesicles. HSV-1 was found on viral culture and direct fluorescent antibody testing. She was diagnosed with eczema herpeticum, an uncommon and potentially life-threatening viral infection that arises in areas of pre-existing dermatosis. Antiviral treatment for eczema herpeticum is very effective, and should be instituted without delay to avoid significant morbidity and mortality.

Topics: Acyclovir; Adult; Antiviral Agents; Codeine; Dermatitis, Allergic Contact; Dermatitis, Atopic; Diagnostic Errors; Disease Susceptibility; Facial Dermatoses; Female; Floxacillin; Herpesvirus 1, Human; Humans; Kaposi Varicelliform Eruption; Morphine; Prednisone; Respiratory Hypersensitivity; Staphylococcal Skin Infections; Valacyclovir; Valine

Topics: Acyclovir; Adolescent; Anti-Bacterial Agents; Antiviral Agents; Cloxacillin; Dermatitis, Atopic; Drug Therapy, Combination; Eyelid Diseases; Female; Follow-Up Studies; Humans; Kaposi Varicelliform Eruption; Ointments; Time Factors; Treatment Outcome

Eczema herpeticum is an acute, disseminated herpes simplex virus infection which remains a feared complication of eczematous skin diseases, especially atopic dermatitis. The vesicular and erosive clinical picture is often accompanied by systemic signs and symptoms. Why some atopic patients experience multiple attacks of eczema herpeticum and others never have the disorder remains a mystery. Patients with severe or untreated atopic dermatitis are more likely to be affected. The pathogenesis appears to involve a complex interplay of factors, including demasking of binding sites for the virus through the dermatitis, failure to up-regulate antiviral proteins and a lack of plasmacytoid dendritic cells. Treatment of choice is systemic acyclovir therapy.

Topics: Acute Disease; Acyclovir; Administration, Oral; Adult; Antiviral Agents; Child; Dermatitis, Atopic; Diagnosis, Differential; Female; Glucocorticoids; Herpes Simplex Virus Vaccines; Humans; Kaposi Varicelliform Eruption; Male; Risk Factors; Time Factors

A 38-year-old man was admitted to the Emergency Department suffering from an exacerbation of atopic dermatitis, fever and a burning sensation in the eyes. He was first treated with systemic corticosteroids. A subsequent dermatological and ophthalmological examination established the diagnosis of Kaposi-Juliusberg disease or eczema herpeticum with bilateral herpetic keratitis. Eczema herpeticum is an uncommon herpes simplex virus infection that occurs in patients with atopic dermatitis. Because it is a possible life-threatening condition, this disease must be recognized by all emergency physicians. The association with herpetic keratitis is not frequent but is a major ophthalmological problem. Treatment consists of the administration of high-dose intravenous acyclovir and acyclovir ophthalmic ointment.

Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Antibodies, Viral; Dermatitis, Atopic; Emergencies; Emergency Medical Services; Fever; Humans; Kaposi Varicelliform Eruption; Keratitis, Herpetic; Male; Simplexvirus; Treatment Outcome

Topics: Acyclovir; Adult; Antiviral Agents; Asthma; Cloxacillin; Dermatitis, Atopic; Humans; Kaposi Varicelliform Eruption; Male; Staphylococcal Infections; Superinfection

Topics: Acyclovir; Adult; Antiviral Agents; Dermatitis, Atopic; Face; Female; Humans; Immunosuppressive Agents; Kaposi Varicelliform Eruption; Ointments; Recurrence; Simplexvirus; Tacrolimus; Virus Activation

Topics: Acyclovir; Adult; Antiviral Agents; Dermatitis, Atopic; Hand Dermatoses; Humans; Kaposi Varicelliform Eruption; Male; Penile Diseases; Recurrence

Topics: Acyclovir; Adult; Antibodies, Viral; Antigens, Viral; Antiviral Agents; Dermatitis, Atopic; Herpesvirus 3, Human; Humans; Kaposi Varicelliform Eruption; Male; Plants

Topics: Acyclovir; Antiviral Agents; Dermatitis, Atopic; Humans; Infant; Kaposi Varicelliform Eruption; Male

Topics: Acyclovir; Anti-Bacterial Agents; Antiviral Agents; Child, Preschool; Cloxacillin; Dermatitis, Atopic; Drug Therapy, Combination; Gentamicins; Humans; Immunoglobulin E; Infant; Kaposi Varicelliform Eruption; Male; Penicillins

Eczema herpeticum (EH) is a potentially life-threatening complication that may occur in children with atopic dermatitis. The clinical and laboratory features of EH as seen in 14 children are reported. The mean age of affected children was 34 months. A rapid viral diagnosis was made in 72 percent of patients. In one-third of patients there was a history of herpes labialis in one or other parent in the previous week. In 28 percent of the children, EH was initially thought to be an exacerbation or impetiginization of the underlying dermatitis. Eleven of 14 children were treated with acyclovir (intravenously in eight, orally in three). All patients recovered without sequelae.

Topics: Acyclovir; Child; Child, Preschool; Dermatitis, Atopic; Female; Herpes Labialis; Humans; Infant; Infant, Newborn; Kaposi Varicelliform Eruption; Male; Simplexvirus

Clinicians at the Department of Dermatology at the University of Mainz saw 63 patients with 75 episodes of eczema herpeticum. An analysis of these cases shows an exceedingly high rate of increased incidence of the disease. From 1969 through 1981, 13 cases were registered, whereas in the years 1982 to 1986 the number of cases was 62. The mean age of the patients was 22.7 years, and 42 patients (56%) were between 15 and 24 years of age. This finding shows that the affected patients are not predominantly infants, as has been reported up to now. Of these patients 5 had one recurrence, two had two recurrences, and one had three recurrences. Acyclovir, used for treatment in 38 cases, led to rapid improvement, whereas therapy with immunoglobulins, antibiotics, and so-called immunostimulating agents did not clearly influence disease duration.

Topics: Acyclovir; Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Dermatitis, Atopic; Female; Humans; Infant; Kaposi Varicelliform Eruption; Male; Middle Aged; Pregnancy; Recurrence

Topics: Acyclovir; Dermatitis, Atopic; Herpes Simplex; Humans; Infant; Male

Topics: Acyclovir; Adolescent; Dermatitis, Atopic; Female; Herpes Simplex; Humans; Male; Pedigree