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Picture of the Month

Hong Dang Bui, MD; Albert H. Arteaga, MD; Nancy J. Wilms, MD; Murray Feingold, MD
Am J Dis Child. 1985;139(7):689-690. doi:10.1001/archpedi.1985.02140090051026.
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Denouement and Discussion 

Eczema Herpeticum (Kaposi's Varicelliform Eruption) 

Manifestations  Eczema herpeticum, or Kaposi's varicelliform eruption, occurs in individuals with atopic dermatitis who acquire a herpes simplex virus infection. Herpes simplex virus type 1 is the common cause of the infection, but herpes simplex virus type 2 has also been implicated.Typically, the lesions appear as grouped vesicles with or without erythema, are painful, itch, progress to umbilication and then rupture, form a crust, and heal. These lesions last from ten days to two weeks, but widespread infection with high fever, malaise, and cutaneous dissemination may take place. This can lead to death and can be secondary to viremia and visceral involvement of the lungs, brain, liver, gastrointestinal tract, and adrenal glands. Mortality ranges from 10% to 50% due to viral dissemination and/or secondary bacterial infection.

Diagnosis  Rapid diagnosis can be made by detection of herpes simplex virus

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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