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Eczema Facts

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.

Update on research in September 2015, Journal of Allergy and Clinical Immunology – Certain genetic variants in a gene (iFNGR1) have been studied to increase susceptibility of atopic dermatitis patients to eczema herpeticum.

Update on May 2017 article on Eczema Herpeticum written by MedicalNewsToday.com

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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What happens when an eczema baby get HFMD

Since last Friday when my baby girl Marcie’s teachers called to say they suspected that she has hand-foot-and-mouth disease (“HFMD”), my life, my hubby’s and Marcie’s have been miserable. Today is the 6th day of her HFMD, counting from Friday, 1st day where red bumps showed up on her hands and in her mouth. Here are some quick questions answered on HFMD, especially what happens when a baby with eczema has it (btw, Marcie is 17th month old).

1. How do you know if your baby has HFMD? Will it be confused with eczema rash?

When I brought Marcie to the doctor to verify if she has HFMD, the doctor did seem to take longer to check but made the diagnosis of HFMD when he saw ulcers in the mouth. Below are some pictures taken from the Singapore’s Health Promotion Board’s website, provided by KK Women’s and Children’s hospital.

HFMD on non-eczema child

2. What is the difference when HFMD happens to a baby with eczema?

In Marcie’s case, it didn’t look much like the above but instead the HFMD red bumps appear where she has been scratching most frequently, like her hand and her foot. I’m not sure if the degree of ulcers got to do with the immune system of the baby, but Marcie, fortunately, did not get red sores on her tongue but her tongue seems to be swollen and she drooled a lot.

HFMD on baby’s eczema foot

3. Did the scratching get worse on the eczema skin patches?

It didn’t for Marcie and instead got less scratching, until when the red HFMD bumps subsided, she started scratching again.

4. Will a parent get the HFMD from the child?

Yes! Especially as I co-sleep with my baby, I actually got flu (fever, sore throat, running nose) a day before the ulcers showed up on my baby.

5. What food does a baby take given there’s ulcers in the mouth?

Hydration is key as a baby drool a lot when the mouth has ulcers. If you google, every child seems to have their own preference in times of HFMD. It was traumatic to come up with ten different meals/food just to get Marcie to eat some, here’s what she did eat if it helps:

a. Hard-boiled egg

b. Steamed bun

c. Yoghurt (she only ate when I let her explore the fridge!)

d. Noodle

e. Baby rice cereal with strawberry sorbet (even then the trick didn’t work after 2 meals)

She did drink her favorite pear juice, some chocolate milk and Vitagen. For the past 6 days, she lost 1 kg, and I’ve lost 2kgs taking care of her!