DermatologyInfectious Disease
Eczema Herpeticum
HSV superinfection of eczematous skin — punched-out vesicles, monomorphic, fever, systemic illness; aciclovir IV.
Source: BAD; NICE CKS
Step 1 of ~2
info
Recognise — Dermatological Emergency
HSV-1 (more commonly) infection of inflamed eczematous skin (or other dermatoses — Darier, Hailey-Hailey, severe burns).
Presentation: rapid onset of monomorphic punched-out vesicles + erosions on background of eczema; clusters; fever, malaise, lymphadenopathy. Often misdiagnosed as bacterial superinfection.
Complications: bacterial superinfection (Staph aureus), viraemia, encephalitis, ocular involvement (corneal scarring), keratitis.
High mortality if untreated, especially in children + immunocompromised.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Ciclosporin · Systemic Immunosuppressant — Eczema / Psoriasis
- Azathioprine · Systemic Immunosuppressant — Eczema / Autoimmune Dermatoses
- Dexamethasone (ICU / ARDS) · Systemic Corticosteroid
- Acitretin · Systemic retinoid (Vitamin A derivative)
- Isotretinoin · Systemic retinoid (Vitamin A derivative) / Anti-acne
- Dapsone · Anti-inflammatory / Antimicrobial
Pathways
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD
Decision support only. Always apply local guidelines and clinical judgement.