Characteristics of atopic children with herpetic superinfections and Kaposi–Juliusberg syndrome: A study of10 cases
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79
Background: Atopic dermatitis (AD) is a chronic and recurrent inflammatory dermatosis. It results from the interaction of genetic and environmental factors, leading to defects in the skin barrier and an inappropriate immunological response. Kaposi varicelliform eruption, or eczema herpeticum, is a viral infection, caused mainly by reactivation of HSV-1, which affects about 3% of patients with AD. The objective of our study is to identify the characteristics of our atopic patients who developed eczema herpeticum. Materials and methods: We conducted a prospective study gathering together all cases of Kaposi’s varicelliform eruption in patients with atopic dermatitis over a period of two years. Results: 10 children, with an average age of 26 months and a sex ratio of 0.6, were observed. A personal or family history of atopy was reported in 7 patients. In terms of disease severity, 2 patients had severe AD, and the others had moderate AD. Clinically, an acute presentation of the eruption was found in all our patients with an average duration of 3 days. A fever was reported in 5 patients, which was associated with irritability. Typical vesicles were found in 8 children, with herpetiform clusters in 5 children. Erosions and crusts were reported in 7 children. All of our patients presented xerosis, and erythematous squamous eczematous plaques were reported in 6 patients. Concerning the location of the lesions, facial involvement was observed in 7 children. Tzanck smear was performed in 3 children. We reported the application of traditional treatment a few days before the onset of herpetic superinfection in 8 children. We also found associated bacterial superinfection in 6 children. All of our patients were hospitalized and received intravenous treatment. Conclusion: Early identification of patients at risk of viral complications is important for the development of effective prevention strategies and new therapeutic options targeting components of the immune system.
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