Localized Herpes Simplex Infections in Atopic Dermatitis

Herpes simplex infections, localized to areas of atopic dermatitis, were documented in ten children. The typical clinical picture consisted of low-grade fever and exacerbation of the eczema with discrete vesicles localized to affected skin, followed by punched-out ulcerations. Recurrent attacks were observed in seven cases and coincided with active attacks of herpes labialis in other family members or close friends, suggesting reinfection as the source. In no patient did a disseminated Kaposi's varicelliform type of eruption develop. Viral cultures in 30 additional patients with acute flares of atopic dermatitis without vesicles or ulcerations failed to disclose any herpes simplex.