Der Hautarzt

, Volume 57, Issue 7, pp 586–591 | Cite as

Eczema herpeticatum

Pathogenese und Therapie
Leitthema

Zusammenfassung

Das Eczema herpeticatum als akute, disseminierte, großflächige Herpes-simplex-Infektion ist auch heute noch eine gefürchtete Komplikation ekzematöser Hauterkrankungen, vor allem des atopischen Ekzems. Das als vesikuloerosive Eruption imponierende Krankheitsbild geht oft mit schweren Allgemeinsymptomen einher. Warum einige Neurodermitiker mehrfach ein Eczema herpeticatum bekommen und andere dagegen nie, ist nicht abschließend geklärt. Patienten mit stark ausgeprägtem oder unbehandeltem atopischen Ekzem erkranken gehäuft. Für die Pathogenese des Eczema herpeticatum scheint ein komplexes Zusammenspiel verschiedener Faktoren ursächlich zu sein, wobei die ekzembedingte Demaskierung der Bindungsstellen, die mangelnde Aufregulation antiviraler Peptide und ein Mangel an plasmazytoiden dendritischen Zellen pathogenetisch relevant sind. Therapie der Wahl ist die systemische Aciclovir-Therapie.

Schlüsselwörter

Eczema herpeticatum Atopisches Ekzem Herpes-simplex-Virus Pathogenese Vesikuloerosive Eruption 

Eczema herpeticum

Pathogenesis and therapy

Abstract

Eczema herpeticum is an acute, disseminated herpes simplex virus infection which remains a feared complication of eczematous skin diseases, especially atopic dermatitis. The vesicular and erosive clinical picture is often accompanied by systemic signs and symptoms. Why some atopic patients experience multiple attacks of eczema herpeticum and others never have the disorder remains a mystery. Patients with severe or untreated atopic dermatitis are more likely to be affected. The pathogenesis appears to involve a complex interplay of factors, including demasking of binding sites for the virus through the dermatitis, failure to up-regulate antiviral proteins and a lack of plasmacytoid dendritic cells. Treatment of choice is systemic acyclovir therapy.

Keywords

Eczema herpeticum Atopic dermatitis Herpes simplex virus Pathogenesis Vesiculoerosive eruption 
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Notes

Danksagung

Frau E. Klein sei für die kritische Durchsicht des Manuskripts gedankt.

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Dermatologie und AllergologieLudwig-Maximilians-Universität MünchenMünchen

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