Herpetic eczema Kaposi

Kaposi's herpetic eczema (synonyms: Kaposi's syndrome, variceleform rash, acute varicelliform pustulosis, acute vacciniform pustulosis) is considered by many dermatologists as the result of the herpes virus attachment to chronic dermatosis, most often to the diffuse neurodermatitis. In this case, there is disseminated skin lesions in the form of vesicles and erosions. Kaposi's herpetic eczema can be a manifestation of both primary herpes and its relapse.

Causes and pathogenesis of Kaposi's herpes eczema

Etiological factors can be herpes simplex virus type I, less often - herpes simplex virus type II.

Children become infected by contact with parents who suffer from herpes of the face and mouth. Risk factors are diffuse neurodermatitis, especially complicated by exfoliative erythroderma. Much less often herpetic eczema Kaposi occurs in Darya disease, thermal burns, pemphigus, bullous pemphigoid, common ichthyosis, fungal mycosis and Wiskott Aldrich syndrome.

Symptoms of herpes eczema Kaposi

Kaposi's herpetic eczema develops sharply, accompanied by a high fever (39-40 ° C) with a severe general condition. On the altered eczema and neurodermatitis skin, as well as on other edematous erythematous areas (more often on the face, neck, chest, hands, forearms, etc.), there are grouped abundant vesicles ranging from millet grains to lentils, rapidly passing into pustules with a characteristic umbilical. Depression in the center and resembling chicken pox. As a result of the opening of the bubbles erosions appear with polycyclic outlines, covered with crusts of yellow-brown color, after the fall of which there are pink spots or secondary pigmentation, extremely rarely - superficial scars. With herpetic eczema, there are lesions of the mucous membrane of the oral cavity, conjunctiva and the cornea. Sometimes the disease occurs severely with the phenomena of meningism, complicated by pneumonia, otitis media, which leads to a fatal outcome.

Histopathology. In the lesion focus, there are vesicle-pustules in the epidermis, ballooning degeneration of epithelial cells, accumulation of neutrophilic leukocytes. Giant multinucleate cells and intracellular inclusions are found.

Differential diagnosis. The disease should be distinguished from chicken pox, vaccine, pyoderma.

Treatment of herpes eczema Kaposi

At treatment prescribe antibiotics, sulfonamides, corticosteroids, interferon (parenteral), antihistamines, fortifying agents, vitamins. Antiviral drugs often use acyclovir (ukaril, herpevir, etc.) inside for 7 days. In severe cases (usually with a primary infection), acyclovir is given IV in a dose of 1.5 kg / day. Valvacyclovir bioavailability when administered orally is 4-6 times higher than that of acyclovir. In mild cases, you can do without antiviral drugs. When superinfection caused by Staphylococcus aureus, erythromycin or other antibiotics are prescribed. Outwardly used liquid Castellani, ointments with antibiotics (heliomycin, lincomycin, etc.). Patients should be isolated. In order to prevent viral complications, children suffering from itching; dermatoses, should not be in contact with persons with herpes who have undergone an acute vaccination.

[1], [2], [3], [4]