Name of the Condition

• Eczema herpeticum
• Also known as Kaposi varicelliform eruption.

Summary

Eczema herpeticum is a severe, widespread skin infection caused by the herpes simplex virus. It often occurs in individuals who have pre-existing skin conditions, such as eczema, and is characterized by painful, pus-filled blisters.

Causes

The condition is caused by an infection with the herpes simplex virus (HSV) in patients with compromised skin barrier functions, typically those who have eczema or atopic dermatitis.

Risk Factors

• Having existing skin conditions like eczema or dermatitis.
• Age: More common in infants and young children.
• Immunocompromised state.
• Direct contact with an individual who has an active HSV infection.

Symptoms

• Painful clusters of blisters or pustules.
• Fever and systemic illness.
• Swollen lymph nodes.
• Possible spread of lesions beyond areas affected by eczema.

Diagnosis

• Visual examination by a healthcare provider.
• Viral cultures or PCR tests from the lesions to detect HSV.
• Tzanck smear to identify herpes virus infections.

Treatment Options

• Antiviral medications, such as acyclovir or valacyclovir, to treat the HSV infection.
• Supportive care for symptoms, including pain management with analgesics.
• In severe cases, hospitalization may be required for intravenous antiviral therapy.

Prognosis and Follow-Up

• With timely and appropriate treatment, eczema herpeticum usually resolves without long-term sequelae.
• Regular follow-ups are important to monitor and manage any skin complications or recurrences of HSV infections.

Complications

• If untreated, it can lead to systemic infections, including bacterial superinfection or potentially life-threatening complications like encephalitis.
• Scarring of the skin due to extensive lesions.

Lifestyle & Prevention

• Managing eczema effectively to maintain a healthy skin barrier.
• Promptly treating any HSV infections.
• Avoiding contact with individuals showing active herpes lesions.

When to Seek Professional Help

• Sudden onset of painful blisters in those with eczema or atopic dermatitis.
• If fever and systemic symptoms accompany skin lesions.
• Rapid worsening or spreading of skin lesions.

Additional Resources

• American Academy of Dermatology: aad.org
• National Eczema Association: nationaleczema.org

Tips for Medical Coders

• Ensure coding accurately reflects the viral nature of the infection in eczema patients by using ICD code B00.0 for eczema herpeticum.
• Double-check patient history for pre-existing eczema or dermatitis, as this information is crucial for accurate documentation and treatment assessment.