HSV infection can occur anywhere on the body. More commonly seen in infants and children with atopic dermatitis, eczemaherpeticum, also known as Kaposi's varicelliform eruption, is a more widely disseminated eruption of HSV (Fig. 80.7). In addition to atopic dermatitis, but also with burns, pemphigus, mycosis fungoides, ichthyosis vulgaris, keratosis follicularis (Darier's disease) and Sézary's syndrome8. A clue to the diagnosis is the presence of monotonous discrete 2-3 mm hemorrhagic crusts. Herpetic whitlow is herpes simplex infection of the digits and commonly affects children and dental and medical personnel who do not routinely use gloves. It can also be acquired via digital/genital contact (Fig. 80.8). Herpes gladiatorum occurs in contact sports such as wrestling and produces a disseminated cutaneous infection after the athlete comes into direct contact with infected lesions. Additional cutaneous manifestations of recurrent HSV infection include erythema multiforme and HSV folliculitis.
Figure 80.7 Eczemaherpeticum in a child with atopic dermatitis. Photograph courtesy of Harvey Blank, M.D.