Kaposi’s varicelliform eruption is a rare and potentially fatal viral infection caused mainly by reactivation of herpes simplex virus. It concomitantly occurs with. Disseminated herpes or vaccinia in the setting of underlying skin diseases is known as Kaposi’s varicelliform eruption (KVE). Patients typically present with. It is autosomal dominant in transmission. Patients with DWD are prone to frequent superinfection including the rare complication of Kaposi varicelliform eruption.
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Mehdi Karray ; Asmahen Souissi. Authors Mehdi Karray 1 ; Asmahen Souissi. Kaposi varicelliform eruption, also called eczema herpeticum, refers to a disseminated skin infection due to a virus that usually leads to erkption vesicular eruptions, occurring in a patient with an underlying cutaneous disease. Although rare, it is potentially life-threatening disorder.
Herpes simplex virus is considered the main causative agent. The most commonly reported cases occur in patients with atopic dermatitis. Clinical features of Kaposi varicelliform eruption include widespread clusters of umbilicated vesicles varicel,iform pustules that evolve into crusted skin erosions.
It occurs more frequently in children, probably due to its relationship with atopic dermatitis.
However, adult cases have been reported. The incidence is not precisely known due to its rarity and the lack of large case series.
The disease equally affects men and women and does not appear to have a specific ethnic predominance. However, the finding of cytoplasmic inclusion bodies in histological examination suggested a viral origin. The mechanisms underlying the pathogenesis of viral reactivation in Kaposi varicelliform eruption remain incompletely understood. It is held that defective skin barrier acting in conjunction with immune deficiencies seems to lead to the development of the disease.
Both eruptkon and humoral immunity dysfunction are implicated. In addition, the Th-2 cytokine environment found in atopic dermatitis seems of crucial importance. A skin vraicelliform is not required to confirm a diagnosis, but if it is performed, histological findings include intra-epidermal blister, acantholysis, multinuclear giant cells with intranuclear inclusion, and ballooning degeneration of the keratinocytes. Patients with Kaposi varicelliform eruption present with a sudden skin eruption of painful clusters of umbilicated vesicles and pustules.
Kaposi’s varicelliform eruption: A case series
Vesiculopustules often evolve into crusted, hemorrhagic, and punched-out skin erosions that may enlarge and coalesce to form extensive denuded areas which are more likely to get a bacterial infection. The distribution of affected skin reflects the crucial role of skin barrier impairment since Kaposi varicelliform eruption begins in areas of underlying dermatosis.
This inaugural topographic distribution may lead to a delayed diagnosis because the eruption is often confused with the pre-existing condition. Kaposi varicelliform eruption may be varicelluform with systemic symptoms such as malaise, high temperature, and swollen lymph nodes. In addition, the disease can be complicated by multiple organ involvements, vaicelliform of the central nervous system, liver, lungs, gastrointestinal tract, and adrenal glands.
Kaposi Varicelliform Eruption – StatPearls – NCBI Bookshelf
It is inexpensive, easily applicable, and quick to perform. However, this method suffers from low sensitivity and does not differentiate between herpes simplex virus 1 and 2, or between herpes simplex virus and varicella-zoster virus. Viral culture and direct fluorescence antibody staining on Tzanck smear are the most reliable techniques for herpes simplex virus detection.
In case of atypical, equivocal, or old lesions, a skin biopsy or polymerase chain reaction may be performed. In fact, a histological examination may confirm a diagnosis that may not have been thought of clinically, whereas polymerase chain reaction will detect viral DNA by Polymerase Chain Reaction. Treatment of Kaposi varicelliform eruption must be instituted with no delay since it is a potentially life-threatening disease. Antiviral therapy is effective in reducing morbidity and preventing complications.
Eruptiion analogs are the antiviral agents most commonly used since they inhibit viral DNA replication. Acyclovir is the most widely studied and prescribed drug for of Kaposi varicelliform eruption. High dose intravenous acyclovir is often necessary for disease control. Most patients achieve resolution of the skin lesions over several days.
Prophylactic treatment with systemic antibiotics varicellform recommended to prevent secondary bacterial infection.
The disease may occur as a primary or a recurrent type of infection.
Kaposi’s Varicelliform Eruption | JAMA Dermatology | JAMA Network
The recurrent type occurs in adulthood and is usually a milder and more localized form, generally presenting without viremia. Risk of ocular involvement exists when herpes simplex virus-associated Kaposi varicelliform eruption affects the face. Ocular anomalies include uveitis, conjunctivitis, keratitis, and blepharitis.
The most serious ophthalmological sequela is herpetic keratitis which may lead to vision loss resulting from corneal scarring. Kaposi varicelliform eruption should be diagnosed accurately since it may have fulminant outcomes. Although there is no consensual therapeutic approach, the early use of antiviral therapy in association with systemic antibiotics is crucial. To access free multiple choice questions on this topic, click here.
This book is distributed under the terms of the Creative Commons Attribution 4. Turn recording back on. National Center for Biotechnology InformationU. StatPearls Publishing; Jan. Show details Treasure Island FL: StatPearls Publishing ; Jan. Affilations 1 Rabta Hospital. Introduction Kaposi varicelliform eruption, also called eczema herpeticum, refers to a disseminated skin infection due to a virus that usually leads to localized vesicular eruptions, occurring in a patient with an underlying cutaneous disease.
The most frequently affected sites are the trunk, neck, and head. The Tzanck smear, viral cultures, skin biopsy, or detection of viral DNA by Polymerase Chain Reaction may be helpful in doubtful cases. Antiviral therapy has been effective but should be started as soon as possible after diagnosis to reduce morbidity and mortality.
Histopathology A skin biopsy is not required to confirm a diagnosis, but if it is performed, histological findings include intra-epidermal blister, acantholysis, multinuclear giant cells with intranuclear inclusion, and ballooning degeneration of the keratinocytes.
History and Physical Patients with Kaposi varicelliform eruption present with a sudden skin eruption of painful clusters of umbilicated vesicles and pustules.
Differential Diagnosis Kaposi varicelliform eruption may be confused with various conditions: Prognosis Kaposi varicelliform eruption is a serious condition that may have fatal outcomes. Pearls and Other Issues Kaposi varicelliform eruption should be diagnosed accurately since it may have fulminant outcomes.
Questions To access free multiple choice questions on this topic, click here. Micali G, Lacarrubba F.
Naoum S, Bencherifa F. Kaposi varicelliform eruption in patients with Darier disease: PubMed Links to PubMed. Similar articles in PubMed. Kaposi’s varicelliform eruption in association with rosacea. J Am Acad Dermatol. Fatal outcome due to bacterial superinfection of eczema herpeticum in a patient with mycosis fungoides. Epub Jun Epub Feb Wetzel S, Wollenberg A.