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Disseminated life-threatening viral skin rash in a child with atopic dermatitis

Astrid Herzum1, Corrado Occella1, Ehab Garibeh1

  • 1Dermatology Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.

Clinical and Experimental Vaccine Research
|May 22, 2023
PubMed

Insights

A toddler with atopic dermatitis developed eczema herpeticum post-measles-mumps-rubella (MMR) vaccination. This case suggests MMR vaccination may influence innate immune responses, potentially triggering herpes simplex virus type 1 outbreaks in susceptible children.

Area of Science:

  • Pediatric Dermatology
  • Immunology
  • Vaccinology

Background:

  • Atopic dermatitis (AD) is a chronic inflammatory skin condition.
  • Eczema herpeticum (EH) is a severe herpes simplex virus infection often complicating AD.
  • The pathogenesis of EH in AD involves immune dysregulation and epidermal barrier defects.

Purpose of the Study:

  • To report a case of eczema herpeticum in a toddler following measles-mumps-rubella (MMR) vaccination.
  • To explore the potential role of MMR vaccination in the manifestation of EH in a patient with atopic dermatitis.

Main Methods:

  • Clinical diagnosis of disseminated vesico-pustular rash.
  • Laboratory confirmation of eczema herpeticum.
  • Case review and hypothesis generation regarding vaccination's role.

Main Results:

  • A toddler with mild atopic dermatitis presented with symptoms of eczema herpeticum 14 days after MMR vaccination.
  • The patient exhibited a disseminated rash, fever, malaise, restlessness, and anorexia.
  • Herpes simplex virus type 1 was confirmed as the causative agent of EH.

Conclusions:

  • Eczema herpeticum can manifest in toddlers with atopic dermatitis after MMR vaccination.
  • MMR vaccination may potentially influence the innate immune response, facilitating EH development in susceptible individuals.
  • Further research is needed to elucidate the precise interplay between AD, viral infections, and vaccination in immune response modulation.

Keywords:
Atopic dermatitisEczemaEczema herpeticumExanthemaMeasles-mumps-rubella vaccine

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