Eczema Herpeticum – What is it and is it dangerous?

Eczema Herpeticum (extract from www.eczemaguide.com)

Eczema herpeticum – this is a term that I keep hearing of moms in forums sharing that their children have repeated eczema herpeticum during the year and also of delayed diagnosis where it’s not identified as herpeticum promptly.

If you search eczema herpeticum’s definition – you’ll see it’s often stated as a rare life-threatening complications that results from infections caused by herpes simplex virus type 1 or 2. The virus enters the child’s body through the defective skin (common in eczema children) and attacks multiple organs, including eyes, brain, lung and liver. However, judging from moms’ feedback, it isn’t that rare, so let’s learn more about it!

Is Eczema Herpeticum Dangerous?

Before we get to that, let’s look at how one gets it. Usually the child comes into contact or catches the virus from someone with cold sores. Cold sores is not dangerous and usually it causes blisters around the mouth and is accompanied with fever or flu-like symptoms. Cold sores is most contagious when there are blisters, but can also spread when there’s no blister as the herpes simplex virus can lie dormant in one’s body. The virus can be spread by kissing, sharing utensils, lip balm or generally, coming into contact with the mucus of the infected person.

Now, here’s the DANGER part – for a child with eczema, the herpes simplex virus can enter the skin and sets off a chain of infections, including large scale bacterial skin infection. The symptoms are:

1. 5-12 days after exposure – Rashes with blisters at eczema lesions/skin patches

2. Spreading of the blisters with yellow pus, accompanied with flu, fever and body aches

3. Blisters start to get painful with bleeding, scabbing

4. Widespread at body parts, usually neck, head, upper body with swollen lymph nodes

If left to run its course, the infections may take over body organs, including the eyes. Should the eczema on your child looks different than normal, and starts to blister with pus, it’s recommended to go to the hospital for a prompt diagnosis and treatment.

Diagnosing and Treating Eczema Herpeticum

Diagnosis can be quickly conducted by antibody staining of the pus filled vesticles or a viral culture test. Sometimes, it may be mistaken as small pox or chicken pox, but in any case, an anti-viral drug such as acyclovir or valaciclovir can be administered. For skin with bacterial infections caused by staph, antibiotics is also given to reduce the secondary infection risk.

Be prompt in going to hospital as research shows that the delay in one day increases hospital stay by 11% and one-third of the patients have staph infections, while 3.9% has blood infected and 3.8% needs to stay in intensive care.

As for why moms are sharing that their children gets repeated attacks, it’s because the virus stays in the child’s body and sometimes when there’s a trigger such as fever/flu or stress, it can set off the virus. Some children need to be on daily anti-viral drug which so far, seems to be minimal long-term negative effect as the drug attacks the virus but not the child.

Learn more about eczema and infection from National Eczema Society here.

A note on Marcie’s experience: When she got chickenpox, she didn’t get the anti-viral drug because her skin wasn’t so bad. When she got Hand-Foot-Mouth-Disease the second time, she was given anti-bacterial antibiotics because her skin looked red and infected.

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29 thoughts on “Eczema Herpeticum – What is it and is it dangerous?

  1. Yeesh, I had this once as a kid. Was in Germany and had it diagnosed & treated by a competent doctor though I never knew what it was. I didn’t know it could progress to the organs. Definitely important to catch it in time.

    • Hi Tiffany!
      My girl hasn’t had eczema herpeticum before, but from what I know, if the rashes progress to blisters with prolonged fever, definitely require visit to doctor.
      Take care!
      Mei

  2. My 10 year old daughter had this 4 years ago, the doctor kept telling me it was chicken pox but after she got really bad we discovered she had this.

    It’s awful, it ended up so bad that she lost the top layers of skin off her legs and caught a secondary infection, she was off from school for a month while we dressed and creamed her legs 3 times a day. My heart goes out to anyone suffering from this.

    My daughter has had eczema since she was born and it is showing no signs of easing up, they have also stopped telling me that she will grow out of it. I had never heard of eczema herpeticum until she got it.

    • Hi Rhonda, Thanks for dropping by my blog and leaving a comments, and sorry to hear of such bad experience in treatment of herpeticum :(
      Hugs, and pray that your girl won’t get it again!
      Mei

  3. Hi,
    My daughter just got eczema herpeticum this past week. She is 4 and has had terrible eczema since birth. I don’t know where she contracted the virus, but she started itching spots that looked far worse than normal eczema on Wednesday. Thursday, the pediatrician told us “it is viral herpes”, gave us aciclovir and a topical steroid and that’s it. I was frustrated and have done a lot of research on it to find the “eczema herpeticum”. Thanks for the blogs and stories everyone – I have been very scared, but find comfort in hearing other moms’ stories.

    • Thanks for dropping by my blog, and hope Cassidy is better now. Your doc did give you what’s commonly prescribed.. maybe too busy to explain more and I’m glad you found some comfort from reading this post :)
      Keep us updated on how the condition goes, keeping my fingers crossed for you it’s one-time and then be so behind it for your family.
      Hugs!
      Mei

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  5. Thanks for the blog. I never know there is this kind of ezcema until reading this. My girl just had chickenpox last week, she still in recovering period (11 days now), the pox has stopped and but still some itchy pox to heal up.
    My husband just got coldsore but didnt touch her at all. We went to see pharmacist and said this was chickenpox. Sometimes it is so hard to judge, but I do hope it WAS chickenpox !

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  7. Hi all my son too has aso had herpeticum ezcema 3 times in last year and has currently just finished anti viral treatment but thing is he finished treatment yesterday afternoon and by last night it had all flared up again, so telephoned hospital to be told take him to your GP tomorrow, he also suffers with discoid ezcema so his skin is in a terrible state and you cannot use steroid creams whilst on anti viral treatment

    • Sorry to hear of this Karen! I know that when my daughter had chicken pox, and just a month ago Shingles!, her eczema got worse. We’re fortunate to survive chickenpox without any med, not that I didn’t want to, but wasn’t aware of the risk then.
      Have a good weekend, take care,
      Mei

  8. Hi am late 30,s I have had a topic eczema all my life, but 7 days ago I got these symptoms, phoned albulance to take me to hospital, they were not interested of the pain I was in. So I made my own way to A+E at St Thomas as they have a dedicated Dermatology department. Have been admitted here for 5 days and on the mend. Was prescribed Flucloxacillin 500mg and Valaciclover 500mg.

    • Hi Shahid,

      Thanks for sharing and hope you got better soon! Do also check with the doc if you should take any preventive measures to reduce the chance of recurring, take care,
      Mei

  9. My son is suffering from eczema herpeticum, he has boils in his hands and legs. now we are applying on him fucicort oinment, cetaphil moisturizer and omnicef antibiotics. its almost 10 days now, hope he will get well soon.

    • Hugs! I hope your son will recover too! I’m not sure about the risk of recurring in kids, but do check with the doc if there’s anyway you can minimize that risk, hugs.. understand it’s very tough time to go through this, take care of yourself too!

  10. I am waiting to hear back from the Dr. regarding the culture test we did on my 11 month old daughter. Both my husband and I have HSV 2 and I am so distraught about this thinking I have given this to my daughter. I am not sure how I could have given it to her…I took a bath with her and maybe that was when it happened. My heart is broken…I don’t understand if she will have this for life like my husband and I do, or if it will go away and not be transferred to someone else?

    • Don’t blame yourself, hugs! I’m not sure if it’s possible to get rid of the virus.. may be more of a case of building a stronger immunity to reduce the chance of it recurring? I only know that my daughter had shingles (very rare for a child of preschooler age) and it happened when someone in her class had HFMD and she was showing signs of coming down with flu.
      Hugs!
      Mei

  11. Hi, I am one of the “victim” of eczema herpeticum. I was only diagnosed after I went to see a competent dermatologist. I was on meds for 4 months and was getting better but the symptoms reoccur. :(

  12. My daughter was just diagnosed today with eczema herpeticum. Im very worried since its herpes. The doctor gave her some antiviral meds but that’s all. He said nothing about being contagious and didn’t explain anything at all. So here i am looking for anything i can read about it online. So thanks!

    • Hi Jennifer! Sorry to hear of the herpeticum! Definitely no sharing of towels and be careful to give her away from anyone with cold sores, I freak out everytime I see someone on the train with sores cos I do think they spread quite easily, at least from what I’ve heard from other eczema sufferers. Also that it recurs quite often.. hope that doesn’t happy for your daughter, hugs!
      Mei

  13. Hi. My son had chicken pox a month ago. My husband has since had shingles. I took my 18 mo daughter to docs. The first doc thought it was chicken pox. I wasn’t convinced as she had a flare up of excema. I took her to out if hours next day when a competent doc told me it was excema herpeticum. I’m getting different stories from docs. One says it’s isolated and the other says my daughter will be susceptible to this ugly virus. My daughter is on acyclovir. Last night I noticed my son getting spots around creases in his knee. I took him to docs this morning and he has the sane thing as his mouth has broken out. Are my two kids going to suffer this? I feel like sucha bad parent. They weren’t near anyone with cold sores only shingles. I’m afraid they will have to suffer this throughout their lives.

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  15. Most of the information above relates to small children. My daughter is 19 and was hospitalized for three weeks with eczema herpeticum. She is a severe asthmatic, allergy, and eczema suffer from birth. About 6 months ago we found a hole in her lung, further tests from her pulminologist found that she had aspergillosis (a fungus that can get into asthmatics blood stream; the fungus is everywhere normal lungs just typically don’t react). Her levels were 21%, that means 21% of her blood was this fungus. She was put on a high dose of steroid treatment (the other option would have been chemo if she did not react to this treatment), the treatment had to be for 3 months. After this she went out of state and had a reaction to something and her eczema flared dramatically, this went on for two months. During that time she encounter some road blocks to her college and job plans, resulting in a very stressful situation. She moved home a month ago, after being home for a week she developed flu like symptoms, then the rash started. In three days the rash went from a small spot on her upper arm to her entire face, neck, torso, back, pelvic line, and butt. She was hospitalized immediately and put on anti virals, antibiotics, morphine and percocete for the pain. This treatment went on for three weeks. The rash went into her eyes and caused her eye to close and scab over, there is still concern regarding her eye sight and the scaring that might have occurred. The author of this blog concluded that this was not a rare condition, however, in working with three infectious disease doctors, and two dermatologist who all have been practicing up to 30+ years, only two of them had seen a case of this and not as severe as this one was. 95% of the adults in the US have antibodies for 7 of the herpes strains, this strain is the 8th and most are never exposed to it. There are currently no long term studies on this virus and how it will affect an adult. Anything can set this off if someone has severe atopic dermatitis and the immune system is depleted as my daughters was from the last 6 months.
    Her current care now that she is home is 8 medication multiple times a day. The worse part now is that all the nerve endings in her skin are growing back and it has caused her eczema to flare. We have four different doctors that we have to follow up with and she must now work with an immunologist to build her ability to fight illness.
    Several posters wanted to know what it looks like; the pox are different from chicken poxs in that they get a dip in them. If a doctor wants to use steroids in the beginning of the virus, question it. This happened to us when my daughter was transferred to another hospital, the admitting doctor decided it had not been diagnosed correctly, even though he himself had not seen it before, and wanted to put her on steroids for “severe eczema” we stopped him and found out later from the infectious disease doctor that it could have made the virus grow even quicker putting her at risk of long term damage to her organs or death.
    We are still learning to deal with this and what will come next. I hope this helps give more insight to this virus. The final thing that I would recommend; when the sores start to heal if the case is severe they might actually join together in big scab areas, there are two things that helped my daughter. The first was zinc oxide it helped to soften the scab and kept them from pealing and bleeding. The second was calmoseptine (like really thick calemine lotion) ointment and then wrapping the areas with viscopaste (gauze infused with zinc oxide). If your child is hospitalized ask to work with wound care, they can help bring relief as the skin starts to heal and help you avoid secondary infection.

    • Thank you so much Diane for your sharing, I’m really encouraged in the sense I can feel you care much about kids (young/older) suffering from eczema herpeticum. It is comments like yours that keep me going in my blog (knowing that people read and care too!) and on my toes (to make sure I get info right).

      On its prevalence, found the following articles:
      Superimposed viral infection is an uncommon complication of atopic dermatitis. Atopic patients are prone to opportunistic infection because their skin barrier is compromised and their immune response may be suppressed.

      Epidemiologic data on eczema herpeticum are scarce; however, there has been an increase in the number of patients treated for the condition in university hospitals in recent years.
      http://www.pediatricsconsultant360.com/content/case-point-eczema-herpeticum-uncommon-complication-atopic-dermatitis from University of Virginia

      In this article that focused on length of stay for eczema herpeticum kids
      January 1, 2001, and March 31, 2010, of 1331 children aged 2 months to 17 years with eczema herpeticum from 42 tertiary care children’s hospitals in the Pediatric Health Information System database.
      http://pediatrics.aappublications.org/content/128/6/1161.full

      In this article,
      There has been little research on the incidence of eczema
      herpeticum, but one study from the Department of
      Dermatology at the University of Mainz, Germany, found a
      sharp rise in incidence in the period from 1969 to 1986 [1].
      From 1969 through 1981, 13 cases were registered, whereas
      for the years 1982 to 1986, the number of cases was 62. It is
      unclear whether the increase in registered cases refl ected
      a genuine change in the epidemiology of atopic eczema/
      herpes simplex or was due to increased reporting.
      http://www.plosmedicine.org/article/fetchObject;jsessionid=FC5BF53A41D750797E5D19C69304D0F3?uri=info%3Adoi%2F10.1371%2Fjournal.pmed.0010012&representation=PDF
      http://www.ncbi.nlm.nih.gov/pubmed/3204177

      In this recent journal, it’s about 3% of eczema patients
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773952/

      Overall, on the incidence, seems like it’s still considered uncommon but increasing incidence, with the two main predictive factors of whether eczema patients will get herpeticum is
      1. Early onset of eczema
      2. Total IgE serum level high

      I gathered also from people clicking on this article from the web and from talks in forums, it is possibly uncommon but not unheard of – in fact, one eczema patient with repeated episodes have shared her story too, see here for Jenny’s account.
      http://eczemablues.com/2013/08/someone-manages-eczema-herpeticum/

      Hugs Diane and hope all’s better for your daughter,
      Mei

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