Eczema Herpeticum: Making the diagnosis in the Emergency Department

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• 作者：James S. Studdiford MD^a ; George P. Valko MD^a ; Laurence J. Belin MPH^a ; Amber R. Stonehouse MD ; ^a
• 关键词：eczema herpeticum ; herpes simplex virus ; atopic dermatitis ; rash ; face
• 刊名：Journal of Emergency Medicine
• 出版年：2011
• 出版时间：February 2011
• 年：2011
• 卷：40
• 期：2
• 页码：167-169
• 全文大小：524 K

文摘

Eczema herpeticum (EH), a form of Kaposi's varicelliform eruption, is the dissemination of herpes simplex virus in the setting of preexisting eczema. We discuss the case of an 18-year-old woman with underlying atopic dermatitis (AD) who presented to an Emergency Department complaining of malaise, fever, and a spreading, burning, vesiculopapular facial rash. She was treated for both presumed impetigo and a flare of her underlying AD with cephalexin, bacitracin ointment, topical steroids, and diphenhydramine. Her condition worsened, and she was seen 3 days later by her primary care physician, who recognized the superimposition of a herpetic infection on her underlying AD and revised the diagnosis to EH. An oral regimen of acyclovir led to prompt resolution of the patient's rash and symptoms. Recognition of EH in the acute care setting is essential for the provision of timely and specific treatment and to avoid the serious sequelae of this condition.