Eczema herpeticum emerging during atopic dermatitis in infancy

Eczema herpeticum (EH) is an acute disseminated viral infection that develops in the presence of an existing skin lesion, often on the ground of atopic dermatitis (AD). Morbidity and mortality of EH can be minimized by starting antiviral therapy at the earliest time in diagnosis.

Herein we report five infants diagnosed with EH in the course of AD treatment. All patients had early onset, moderate to severe AD and needed intermittent topical corticosteroid (TCS) therapy. In physical examination, newly formed, TCS-resistant vesiculo-papular skin lesions were recognised on the present dermatitis. The presence of AD with food allergy and moderate to severe eosinophilia were other prominent findings.

All patients were misdiagnosed as AD exacerbation. Therefore, EH should be considered in the differential diagnosis of AD exacerbation especially in the infants with moderate to severe AD.