Disseminated coxsackievirus A6 affecting children with atopic dermatitis

Area of Science:

• Virology
• Dermatology
• Pediatrics

Background:

• Coxsackievirus A6 (CV-A6) is an emerging viral pathogen.
• CV-A6 is increasingly associated with atypical presentations of hand, foot, and mouth disease.
• Atopic dermatitis (AD) is a common chronic inflammatory skin condition in children.

Purpose of the Study:

• To report a series of children in the UK with disseminated CV-A6 infection.
• To describe the clinical presentation of CV-A6 infection in children with atopic dermatitis.
• To highlight CV-A6 as a differential diagnosis for acute exacerbations of AD.

Main Methods:

• Retrospective case series.
• Clinical data collection from six pediatric patients presenting to a single UK center.
• Description of dermatological manifestations and association with atopic dermatitis.

Main Results:

• Six children with atopic dermatitis presented with disseminated papular or vesicular eruptions.
• The CV-A6 infection presented as a widespread rash, distinct from typical eczema herpeticum.
• Lesions were generalized, discrete, and less circumscribed than typical herpetic lesions.

Conclusions:

• CV-A6 infection occurs in the UK and can present atypically in children with atopic dermatitis.
• Disseminated CV-A6 infection should be considered in the differential diagnosis of acute AD exacerbations.
• This presentation underscores the importance of recognizing emerging viral infections in immunocompromised or atopic individuals.