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KMID : 0363220130510110893
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Korean Journal of Dermatology
2013 Volume.51 No. 11 p.893 ~ p.897
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Two Cases of Widespread Eczema Herpeticum with Low Serum Vitamin D Levels
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Kim Soo-Min
Jang Gwang-Cheon
Kim Yee-Jeong
Cho Nam-Joon
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Abstract
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Eczema herpeticum is a disseminated herpes simplex virus infection mainly in atopic individuals. Low expression of cathelicidin in atopic dermatitis contributes to the lack of defense capability against viral infection. Serum vitamin D level, which is essential for cathelicidin induction, is reported to be low in patients with severe atopic dermatitis. However, serum vitamin D level has not been studied in patients with eczema herpeticum. The mainstay of treatment of eczema herpeticum is systemic antiviral therapy. In atopic individuals with eczema herpeticum, intravenous immunoglobulin is less likely to enhance cutaneous viral susceptibility than other immunomodulators. Herein, we report two pediatric cases of widespread eczema herpeticum, both accompanied by high fever and low serum vitamin D levels. The patients were successfully treated with intravenous acyclovir and intravenous immunoglobulin. Serum 25-hydroxyvitamin D3 level was even less than 4.0 ng/ml in one patient, and no more repeated episodes of eczema herpeticum occurred, after supplementation of vitamin D.
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KEYWORD
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Atopic dermatitis, Cathelicidin, Eczema herpeticum, Intravenous immunoglobulin, Vitamin D
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