Korean J Dermatol.  2013 Nov;51(11):893-897.

Two Cases of Widespread Eczema Herpeticum with Low Serum Vitamin D Levels

• Kim SM
• Jang GC
• Kim YJ
• Cho NJ

Abstract

Eczema herpeticum is a disseminated herpes simplex virus infection mainly in atopic individuals. Low expression of cathelicidin in atopic dermatitis contributes to the lack of defense capability against viral infection. Serum vitamin D level, which is essential for cathelicidin induction, is reported to be low in patients with severe atopic dermatitis. However, serum vitamin D level has not been studied in patients with eczema herpeticum. The mainstay of treatment of eczema herpeticum is systemic antiviral therapy. In atopic individuals with eczema herpeticum, intravenous immunoglobulin is less likely to enhance cutaneous viral susceptibility than other immunomodulators. Herein, we report two pediatric cases of widespread eczema herpeticum, both accompanied by high fever and low serum vitamin D levels. The patients were successfully treated with intravenous acyclovir and intravenous immunoglobulin. Serum 25-hydroxyvitamin D3 level was even less than 4.0 ng/ml in one patient, and no more repeated episodes of eczema herpeticum occurred, after supplementation of vitamin D.

Keyword

Atopic dermatitis; Cathelicidin; Eczema herpeticum; Intravenous immunoglobulin; Vitamin D

MeSH Terms

Acyclovir
Calcifediol
Dermatitis, Atopic
Eczema*
Fever
Humans
Immunoglobulins
Immunologic Factors
Kaposi Varicelliform Eruption*
Simplexvirus
Vitamin D*
Vitamins*
Acyclovir
Calcifediol
Immunoglobulins
Immunologic Factors
Vitamin D
Vitamins