Abstract
Kaposi's varicelliform eruption is characterized by a diffuse eruption of vesicles, most of which are umbilicated and grouped and develop successive crops. It is a clinical condition seen when a wide spread infection with vaccina or herpes simplex viruses occurs in a patient with a preexisting skin condition. The disease most commonly occurs with atopic dermatitis or Darier's disease, and the terms “eczema vaccinatum” and “eczema herpeticum” are synonyms.
We recently experienced a case of Kaposi's varicelliform eruption in a 18-year-old man secondary to atopic dermatitis complicated by herpes simplex virus infection.
He came to our clinic on May 10, 1983 with a chief complaint of dysphagia. Four days prior to admission, a painful vesicular eruption developed on his chin to neck followed by swelling of bilateral submandibular lymph nodes. The lesions were spreaded to face and upper trunk with fever 2 days prior to admission. Treatments including γ-globulin were performed by a certain dermatologist without success. On the first examination, the body temperature was 37.3°C and there was tender enlargement of bilateral submandibular lymph nodes. Umbilicated vesicles of 2-3mm in diameter were observed in cluster from face to neck. There was no vesicles and ulcerative lesions in oral mucosa. He was immediately hospitalized and administration of antibiotics and anti-inflammation drugs were started. To prevent secondary bacterial infection, he was given minocycline 200mg twice daily, cefaclor 500mg three times daily and ointment of mixed tetracycline and betamethasone topically. The vesicular lesions evolved into pustules which then became crusted. Pigmentation and superficial scars remained in the some area. He was discharged on May 28, 1983 and eventually healed.
When serum of this patient was assayed for antibody titer against herpes simplex virus by complement fixation test at various time intervals during the therapeutic period, this antibody titer during the recovery period showed four fold increase in comparison to that at onset of the disease.
Relapse of symptoms similar to those noted previously occurred about 11 months later, however, the lesions lasted about 2 weeks and cleared completely.
