Eczema Herpeticum

Eczema Herpeticum

Small punctate lesions on the skin with blister forming at early stage before they burst open. Similar condition in the oral cavity is called canker sore or cold sore. However, due to the more “loose” mucosa tissues, the ulceration is larger than in the skin. Those lesions are “burn-out” peripheral nerve endings due to viral reactivation at peripheral nerves. 

Eczema herpeticum is a skin infection condition that commonly seen in patients with history of eczema or atopic dermatitis (skin inflammation due to allergies). It is described as small punctate lesions on the skin or papulovesicular eruption. This type of infection is actually due to viral reactivation causing peripheral sensory nerve inflammation. The small punctate like lesions on the skin are actually sites of sensory nerve ending inflammation and damage. Although most of eczema herpeticum are due to reactivation of Herpes Virus type 1 due to high prevalence of HSV1 infection status among age 14 to 49 group (about 48.1% in the US), other types of herpes-like viruses like HSV2, coxsackie virus, vaccinia and small pox also cause similar presentation. Those herpes-like skin eruption are together named Kaposi’s varicelliform eruption (KVE).

In our practice, this type of skin condition occurs a lot more common in patients with atopic dermatitis or allergies in general. Beside treatment for acute flare up, controlling allergic inflammation also shown to reduce the frequency of reactivation.

When you have active lesions, your physician will prescribe a course of antiviral medication for at least 2 weeks or until the lesions heal. If this condition occurs many times a year, you might also need to be on a small dose of antivirals daily for a few months to suppress the reactivation of the virus.

Please come for a discussion if you or your family member has or suspects to have any of those diseases to see how we could help. Below are services and procedures that we offer at Texas Allergy for this condition.

  • Skin care education and teaching
  • Identiy and control triggers, which are many as mentioned above
  • Allergy test and treatment
  • Using of non-steroid agent and biologics for maintanance of recurring severe cases if indicated
  • Primary immunodeficiency evaluation if indicated, especially in infant or young children
  • Disease modifying agents and biologics/monocloncal antibodies in case of failure from these above methods.
  • Inpatient hospitalization care in severe cases of eczema
  • Please see our specialized Eczema Clinic for more information