Hand eczema herpeticum.

Eczema herpeticum consists of a primary herpes simplex virus infection superimposed on a pre-existing dermatosis. Localized forms of this condition also occur. A twenty-three-year-old woman showed a primary herpes simplex virus infection in the areas of her residual atopic hand eczema after contact with her eighteen-month-old son's oral cavity, which was infected with herpes simplex type I. Possible theories about pathogenesis include a temporary deficit in cell-mediated immunity, defective interleukin production, or persistent alteration of the affected skin. Use of acyclovir resulted in rapid clearing of the eruption. Herpes simplex virus infection should be considered in the differential diagnosis when a flare or vesiculation occurs in patients with atopic hand eczema.