关键词: Dermatose Dermatosis Eczema herpeticum HSV Herpes Herpès Kaposi varicelliform eruption Surinfection

Mesh : Administration, Cutaneous Adult Aged Aged, 80 and over Antiviral Agents / administration & dosage Diagnosis, Differential Drug Therapy, Combination Female Glucocorticoids / administration & dosage Humans Immunocompromised Host Inpatients Kaposi Varicelliform Eruption / complications diagnosis drug therapy Male Middle Aged Retrospective Studies Skin Diseases / complications diagnosis drug therapy Superinfection Treatment Outcome

来  源:   DOI:10.1016/j.annder.2017.01.011   PDF(Sci-hub)

Abstract:
BACKGROUND: Although varicelliform Kaposi eruption is a well-known complication of dermatoses, it has not been widely investigated.
OBJECTIVE: To investigate features of dermatoses and herpes superinfection in patients hospitalized in a dermatology department.
METHODS: We performed a single-centre, retrospective study between 2008 and 2014 that included cases of Kaposi varicelliform eruptions defined by positive PCR of an unconventional site of herpetic recurrence in a setting of active dermatitis. A record was compiled of each case giving details of the history, clinical and laboratory findings, therapeutic data and outcome.
RESULTS: Thirty-four cases of Kaposi varicelliform eruptions in 30 subjects were studied. Mean age at diagnosis was 63.3±24.2 years. The underlying dermatoses were as follows: 7 pemphigus, 6 bullous pemphigoid, 3 cicatricial pemphigoid, 3 atopic dermatitis, 1 Darier disease, and 14 other dermatoses. Patients presented with skin (94.1 %) or mucous membrane lesions (62 %), mostly erosive (79 %), vesicular (27 %) or bullous (41 %), often painful (56 %) or pruritic (29 %). At diagnosis, 41.2 % were undergoing systemic immunotherapy and 24 % were on topical corticosteroids. PCR was positive for HSV1 in 20 cases and for HSV2 in 4 cases, and indeterminate in 10 cases. Lymphocytopenia was seen in 59 % of cases. The majority of patients received treatment. Nine patients experienced at least one relapse.
CONCLUSIONS: Our study confirms the over-representation not only of the expected dermatoses (pemphigus and atopic dermatitis), but also of others such as pemphigoid and acute dermatoses; these results should be investigated in a more systematic prospective study.
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