Studdiford James S, Valko George P, Belin Laurence J, Stonehouse Amber R
Department of Family and Community Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
J Emerg Med. 2011 Feb;40(2):167-9. doi: 10.1016/j.jemermed.2007.11.049. Epub 2008 Jun 27.
Eczema herpeticum (EH), a form of Kaposi's varicelliform eruption, is the dissemination of herpes simplex virus in the setting of preexisting eczema. We discuss the case of an 18-year-old woman with underlying atopic dermatitis (AD) who presented to an Emergency Department complaining of malaise, fever, and a spreading, burning, vesiculopapular facial rash. She was treated for both presumed impetigo and a flare of her underlying AD with cephalexin, bacitracin ointment, topical steroids, and diphenhydramine. Her condition worsened, and she was seen 3 days later by her primary care physician, who recognized the superimposition of a herpetic infection on her underlying AD and revised the diagnosis to EH. An oral regimen of acyclovir led to prompt resolution of the patient's rash and symptoms. Recognition of EH in the acute care setting is essential for the provision of timely and specific treatment and to avoid the serious sequelae of this condition.
疱疹样湿疹（EH）是卡波西水痘样疹的一种形式，是单纯疱疹病毒在已有湿疹的情况下播散所致。我们讨论一例18岁患有特应性皮炎（AD）的女性病例，她因全身不适、发热以及面部出现扩散性、灼痛性水疱丘疹性皮疹而就诊于急诊科。她接受了头孢氨苄、杆菌肽软膏、外用类固醇和苯海拉明治疗，诊断考虑脓疱病和基础AD的发作。她的病情恶化，3天后其初级保健医生对她进行了诊治，该医生认识到在其基础AD上叠加了疱疹感染，并将诊断修正为EH。口服阿昔洛韦治疗方案使患者的皮疹和症状迅速消退。在急症治疗环境中识别EH对于提供及时和特异性治疗以及避免该疾病的严重后遗症至关重要。
