Putting Eczema Herpeticum Into Perspective

Eczema Herpeticum

Because the skin acts as a protective barrier between the outside world and your vital organs, taking care of it is important. Those suffering from eczema herpeticum may feel as though there’s little hope of ever looking and feeling comfortable in their skin again. However, modern science has made some huge discoveries in the realm of dermatological health that may shed some light on this otherwise painful and embarrassing condition.

What is Eczema Herpeticum?

Rare but equally as severe, eczema herpeticum is a disseminated skin infection that resembles chickenpox in appearance. Typically, it occurs on or around spots on the skin that have been exposed to or damaged by an outside force such as extreme heat (burns) or prolonged use of topical steroids. It’s also common among those with existing eczema/atopic dermatitis.

When eczema herpeticum lesions appear on the skin, they become known as Kaposi varicelliform eruptions. The condition is often accompanied by a fever as well as numerous small, itchy blisters or the subsequently hollowed out pits thereof. Not only is eczema herpeticum painful but it’s also unattractive and can affect the hands, face or any other part of the body.

How Is Eczema Herpeticum Caused?

Most often associated with a complication regarding existing eczema/atopic dermatitis, eczema herpeticum is actually caused by the Herpes simplex type 1 or 2 virus. Typically, lesions appear within a few days of coming in contact with an infected person. It does not matter whether the infected person had visible cold sores or not. As such, eczema herpeticum can complicate matters for those already dealing with recurrent primary herpes. The good news is that repetitive episodes of eczema herpeticum are extremely rare.

Are There Any Risk Factors?

Unfortunately, eczema herpeticum can affect anyone regardless of their age, sex, gender, race, nationality or any other factor. Interestingly, it’s seen more often in infants born with atopic dermatitis than it is in adults who have been exposed to the herpes virus. As it turns out, the lowered immunities that accompany atopic dermatitis tend to leave individuals more susceptible to a herpes infection. It does not matter whether the underlying dermatitis is active or not, nor does its severity play a role.

Symptoms and Clinical Characteristics

Although eczema herpeticum blisters can appear on any part of the body in very rare cases, they most often occur on the face and/or neck. Blisters are monomorphic and vary in size but can show up on normal, undamaged patches of skin as well as in areas that have been previously affected by eczema/atopic dermatitis. Furthermore, patches of eczema herpeticum blisters typically spread rapidly only for the first 7-10 days but that’s not always the case. Depending on the person’s immunities, blister outbreaks can be much more severe or longer lasting than average.

Eczema herpeticum blisters tend to have the following general characteristics:

  • Filled with fluid/material that’s either clear and yellowish or thick and purulent
  • Stained with blood, exhibiting a red, black or purple color
  • Umbilication (dimples) in the center of the new blisters

Keep in mind that older eczema herpeticum blisters can crust over during the healing process, forming unsightly sores, or “erosions.” Typically, blisters heal by about six weeks, although severe infections have been known to persist for much longer and can even completely destroy the skin with small, permanent white scars.

NOTE: Considered one of the very few dermatological emergencies, severe and/or untreated eczema herpeticum, or EH, can negatively affect certain organs including the brain, lungs, liver and eyes. In extremely rare cases, it can even be fatal.

The Best Treatments for Eczema Herpeticum

Although unchecked eczema herpeticum can be potentially deadly, getting immediate and adequate antiviral treatment by a doctor should prevent the need for further medical attention or hospitalization. Usually, antiviral treatments are administered via oral tablets. However, some doctors will use intravenous medication if the patient is unable to swallow tablets or if the infection is getting out of control.

Treatments for Secondary Infections

Moreover, eczema herpeticum often leads to secondary infections on the skin caused by the body’s inability to kill harmful bacterium. As such, systemic antibiotics are often given to patients undergoing treatment for EH blisters. Topical steroid medications are not generally used to treat eczema herpeticum because they can exacerbate the problem. However, topical steroids are sometimes used to treat active cases of atopic dermatitis, even cases related to EH.

Diagnosis: How to Tell If You Have Eczema Herpeticum

Watch for the presence of small, uniform bumps or blisters on your face and/or neck. Take note if you begin to experience involuntary eye movements, measure any high body temperatures or have trouble doing routine tasks.

Diagnosing eczema herpeticum is not difficult in a clinical setting. Patients usually have painful monomorphic blisters, low grade fever, and present with general malaise. Qualified physicians will then confirm the prognosis using a variety of testing tools, including viral cultures which scrape the base material from a fresh blister before being compared with healthy cells in a lab. In some cases, a skin biopsy may be required to rule out other medical conditions.

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