by EBSCO Medical Review Board
(Kaposi’s Varicelliform Eruption)

Definition

Eczema herpeticum is a serious skin infection. It is a painful rash that starts with pus-filled red bumps. The bumps then turn into sores. The rash can spread quickly over the skin. Sometimes it can spread to other organs, such as eyes or brain.

Causes

The herpes virus causes eczema herpeticum. The virus enters the body through breaks in the skin. The virus may come from somewhere else on the body like a cold sore on the lips. The virus can also be passed from someone else who has a herpes infection. Common herpes infections include cold sores on the lips and genital herpes.

Skin problems can damage and cause breaks in the skin. These problems may also make it harder for the body to fight infections. This is why eczema herpeticum is more common on those with other skin problems.

Risk Factors

Eczema herpeticum is most common in people with eczema. It is more common in children than adults, but it can happen at any age. Other things that increase the risk of eczema herpeticum are:

  • Eczema at an earlier age
  • Allergies or asthma
  • Immune system problems
  • Frequent past herpes infections

Symptoms

Eczema herpeticum can cause:

  • Clusters of painful, itchy blisters
  • Blisters that bleed or ooze fluid or pus
  • Blisters that crust over and leave sores

The rash happens most often on the head, neck, and upper part of the body.

Other symptoms that happen with the rash:

  • Fever
  • Swollen glands
  • General feeling of illness

Diagnosis

The doctor will ask about your symptoms and past health. The skin will be examined. The doctor may make a diagnosis based on your answers and the exam.

The doctor may take samples of fluid or pus from the blister. The samples are looked at in a lab. It will show which germ is causing the problem.

Treatment

Eczema herpeticum needs to be treated right away. An antiviral medicine will help to clear the infection. A hospital stay may be needed for severe infections.

The sores from the rash can increase the risk of a second infection. This type of infection is often caused by bacteria. Antibiotics may be given to stop this second infection. It may only be needed for those with weaker immune systems.

Some will be at risk for more infections. Lon- term antiviral medicine may be needed to prevent new infections.

Prevention

A doctor can help to create a care plan for skin problems. Good care can lower the risk of skin damage and infections.

RESOURCES

American Academy of Dermatology  https://www.aad.org 

Kids Health—Nemours Foundation  https://kidshealth.org 

CANADIAN RESOURCES

Caring for Kids—Canadian Paediatric Society  https://www.caringforkids.cps.ca 

Health Canada  https://www.canada.ca 

References

Eczema herpeticum. DermNet NZ website. Available at: https://www.dermnetnz.org/topics/eczema-herpeticum. Accessed July 23, 2019.

Eczema herpeticum. EBSCO DynaMed website. Available at:  https://www.dynamed.com/topics/dmp~AN~T116465/Eczema-herpeticum . June 5, 2017. Accessed July 23, 2019.

Eczema herpeticum. Patient website. Available at: https://patient.info/skin-conditions/atopic-eczema/eczema-herpeticum. Updated May 14, 2018. Accessed July 23, 2019.

Liaw FY, Huang CF, et al. Eczema herpeticum: a medical emergency. Can Fam Physician. 2012;58(12):1358-1361.

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 06/2020
  • Update Date: 07/10/2020