Seegräber M, Worm M, Werfel T, Svensson A, Novak N, Simon D, Darsow U, Augustin M, Wollenberg A
Department of Dermatology and Allergy, Ludwig-Maximilian-University, Munich, Germany.
Department of Dermatology and Allergy, Charité Universitätsmedizin Berlin, Berlin, Germany.
J Eur Acad Dermatol Venereol. 2020 May;34(5):1074-1079. doi: 10.1111/jdv.16090. Epub 2020 Jan 30.
Eczema herpeticum (EH) is a disseminated viral infection of eczematous skin disease with the herpes simplex virus. Knowledge on clinical characteristics, risk factors and recurrent disease is limited. Our aim was to better define clinical characteristics and risk factors for EH and especially for recurrent EH.
A retrospective analysis of EH cases assessed the history, clinical signs, prior treatment and laboratory results using a predefined questionnaire.
A total of 224 EH cases from eight European centres were included. Extrinsic AD was identified as risk factor for EH, and only one patient suffered from intrinsic AD. Early onset of AD was identified as risk factor for recurrent EH. Pretreatment with topical steroids, systemic steroids, topical calcineurin inhibitors or plain emollients reflected standard therapy. Many patients showed AD lesions without EH, but skin without AD lesions was never affected by herpetic lesions.
Patients with clinically active, extrinsic AD are at risk of EH. Recurrent EH is associated with confounders of severe atopic distortion and requires active AD lesions for clinical manifestation. Recurrent eczema herpeticum mainly affects patients with early onset of AD.
疱疹样湿疹（EH）是一种由单纯疱疹病毒引起的湿疹性皮肤病的播散性病毒感染。关于其临床特征、危险因素和复发性疾病的知识有限。我们的目的是更好地界定EH尤其是复发性EH的临床特征和危险因素。
对EH病例进行回顾性分析，使用预定义问卷评估病史、临床体征、既往治疗及实验室检查结果。
纳入了来自八个欧洲中心的224例EH病例。特应性皮炎（AD）外在型被确定为EH的危险因素，仅有1例患者患有AD内在型。AD的早发被确定为复发性EH的危险因素。外用糖皮质激素、系统糖皮质激素、外用钙调神经磷酸酶抑制剂或单纯润肤剂预处理反映了标准治疗。许多患者有AD皮损但无EH，而无AD皮损的皮肤从未出现疱疹样皮损。
临床上有活动的AD外在型患者有发生EH的风险。复发性EH与重度特应性畸变的混杂因素相关，且临床表现需要有活动的AD皮损。复发性疱疹样湿疹主要影响AD早发患者。
