Eczema herpeticum has been covered in this blog before, and for the past few months, there seem to be more parents contacting me or commenting on this topic. There are a few key questions, with the main one being whether a child with eczema/atopic dermatitis is more susceptible to eczema herpeticum and whether once a child gets it, he/she will keep getting it. Let’s look into research in this area:
Quick Basics of Eczema Herpeticum
Eczema herpeticum happens when a patient with eczema gets infected with the herpes simplex virus, the same virus responsible for cold sores. Symptoms of eczema herpeticum are painful, rapidly worsening eczema with blisters, sores, accompanied by fever. A child can get the virus from sharing towel or in general, coming into contact with the mucus of someone who has the virus (who may not necessarily have the cold sores/ herpeticum).
Treatment includes anti-viral medication, oral acyclovir. In view of how fast the drug can work to control the herpeticum in conjunction with the increasing length of hospital stay when not treated fast enough, it is usually advisable to administer acyclovir expediently (see article here, here and here).
Are Children with Eczema/ Atopic Dermatitis more prone to Eczema Herpeticum?
Yes, generally due to the defective skin barrier and lower immune system, eczema kids ‘catch’ skin infection much easier. This article suggest that those with skin inflammation that is uncontrolled are more likely to get eczema herpeticum. Other possible hypothesis of eczema kids getting herpeticum involve the gene, gene expression (also here), filaggrin, history of food allergy/asthma and early onset of AD.
Will Eczema Herpeticum Recur?
Yes, and it is also possible to get secondary bacterial infection, i.e. from Staph aureus bacteria. For more on staph, see here. I’ve found a study (on mice) that noted the mice infected with staph bacteria get higher penetration of the herpes virus. More on herpeticum here.
It is quite often heard of delayed administration of the anti-viral drug because of misdiagnosis, being confused with impetigo. Anti-bacterial drug will not treat herpeticum and delayed treatment can severely affect the body, leading to blindness (keratoconjunctivitis) and death. Hospitalization was required for half of the patients, and those who are hospitalized had a higher likelihood of recurrence (article here).
Share your experience in this post, esp. when studies in this area is difficult to conduct, experiences may just help!