Herpes simplex virus in childhood erythema multiforme

Area of Science:

• Pediatric Dermatology
• Infectious Diseases
• Molecular Virology

Background:

• The association between herpes simplex virus (HSV) and erythema multiforme (EM) minor is established in adults.
• This link has not been previously reported or investigated in the pediatric population.
• Understanding triggers for EM minor in children is essential for accurate diagnosis and treatment.

Purpose of the Study:

• To investigate the role of HSV infection in the pathogenesis of EM minor in children.
• To determine the prevalence of HSV in pediatric EM minor skin lesions.
• To compare HSV detection rates in children with and without a history of herpes infection.

Main Methods:

• Analysis of skin lesions from 20 pediatric patients (ages 1-16) meeting EM minor criteria.
• Polymerase chain reaction (PCR) used to detect HSV DNA in lesional skin.
• In situ hybridization employed to confirm and localize HSV within skin biopsies.

Main Results:

• HSV DNA was detected in 80% (8/10) of children with a history of herpes infection.
• HSV DNA was also detected in 80% (8/10) of children with no prior herpes infection history.
• HSV was localized to the epidermis in lesional skin, and absent in normal skin controls.

Conclusions:

• Herpes simplex virus is a significant precipitating factor for EM minor in children.
• HSV should be suspected in pediatric EM minor cases, irrespective of a known herpes infection history.
• These findings highlight the importance of considering HSV in the differential diagnosis of EM minor in pediatric patients.