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Eczema herpeticatum

Eczema herpeticatum

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Zusammenfassung

Patienten mit atopischem Ekzem neigen zu viralen Infektionen der Haut. Das Eczema herpeticatum ist die disseminierte Infektion eines vorbestehenden, zumeist atopischen Ekzems mit dem Herpes-simplex-Virus und stellt eine auch heute noch gefürchtete Komplikation des atopischen Ekzems dar. Das Erscheinungsbild einer monomorphen vesikuloerosiven Eruption auf ekzematöser Haut bei teils schweren Allgemeinsymptomen ist diagnostisch richtungsweisend. Die klinische Diagnose kann durch Polymerasekettenreaktion, Viruskultur, elektronenmikroskopischen Virusdirektnachweis in Negativkontrastierung, Tzanck-Test, Immunfluoreszenzuntersuchungen oder serologische Untersuchungen bestätigt werden. Zur Standardtherapie des Eczema herpeticatum, der intravenösen antiviralen Chemotherapie mit Aciclovir, wurden in den letzen Jahren mehrere therapeutische Alternativen entwickelt.

Abstract

Patients affected by atopic dermatitis tend to develop viral infections. Probably the most feared complication of atopic dermatitis is eczema herpeticum, a disseminated infection with herpes simplex virus. A monomorphic eruption of dome-shaped blisters, pustules and erosions in the eczematous skin lesions along with severe systemic illness leads to the diagnosis. The clinical diagnosis may be confirmed by polymerase chain reaction, viral culture, electron microscopy with negative staining, Tzanck test, immunofluorescence tests or serology. While intravenous acyclovir is still regarded as standard treatment of eczema herpeticum, several recently-developed antiviral drugs provide therapeutic options.

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Danksagung

Herrn Prof. Dr. Dr. h.c. G. Plewig, Frau Dr. K. Kerschenlohr und Herrn Dr. W. Pfützner sei für die kritische Durchsicht des Manuskripts gedankt.

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  1. Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München, München

    S. Wetzel &  A. Wollenberg

  2. Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München, Frauenlobstraße 9–11, 80337 , München

    A. Wollenberg

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Wetzel, S., Wollenberg, A. Eczema herpeticatum. Hautarzt 55, 646–652 (2004). https://doi.org/10.1007/s00105-004-0744-1

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