Friday, November 16, 2007

Eczema herpeticum

A 2-year-old boy presented with a 3-day history of vesicular eruptions on the mouth followed by extensive pruritic skin eruptions on the upper and lower limbs. This was preceded by fever. He was otherwise well.

Examination of the skin showed extensive eczematous lesions on the lower and upper limbs. Excoriations, erosions and vesicles were also noted on the affected areas. Vesicular lesions and erosions were noted around the mouth. He was afebrile.

Clinically he has eczema herpeticum.

This is disseminated herpes infection at sites of epidermal disruptions. He was treated with oral acyclovir 50mg 5x daily and oral cloxacillin 125mg qid. Wet compresses with diluted KMNO4 and topical mometasone cream was used for the weepy eczematous eruptions. The lesions gradually subsided with the treatment.


  1. Yes typical case of eczema herpeticum and good treatment. As far i know very often is associated with Atopic dermatitis.

  2. I agree with your dx.
    1) Was a Tzanck smear done?
    2) suspect that the child woud have cleared with time alone. I saw similar cases in the early 1980s before acyclovir was approved and they did fine with Domeo Boro's cc\ool compresses.


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