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July 1985

Picture of the Month

Author Affiliations

Contributed from the Departments of Pediatrics (Drs Bui and Arteaga) and Medicine (Dr Wilms), Loma Linda (Calif) University School of Medicine.

Am J Dis Child. 1985;139(7):689-690. doi:10.1001/archpedi.1985.02140090051026

Denouement and Discussion 

Eczema Herpeticum (Kaposi's Varicelliform Eruption) 

Manifestations  Eczema herpeticum, or Kaposi's varicelliform eruption, occurs in individuals with atopic dermatitis who acquire a herpes simplex virus infection. Herpes simplex virus type 1 is the common cause of the infection, but herpes simplex virus type 2 has also been implicated.Typically, the lesions appear as grouped vesicles with or without erythema, are painful, itch, progress to umbilication and then rupture, form a crust, and heal. These lesions last from ten days to two weeks, but widespread infection with high fever, malaise, and cutaneous dissemination may take place. This can lead to death and can be secondary to viremia and visceral involvement of the lungs, brain, liver, gastrointestinal tract, and adrenal glands. Mortality ranges from 10% to 50% due to viral dissemination and/or secondary bacterial infection.

Diagnosis  Rapid diagnosis can be made by detection of herpes simplex virus