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Eczema herpeticum

机译：湿疹herpetemum

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28-year-old male patient, diagnosed with atopic dermatitis since early childhood medicated solely with topical immunosuppressants (clobetasol propionate and pimecrolimus). Presented himself in the emergency department (ED) with a one-day history of pain and swelling of the right retromandibular area with extension to the ipsilateral ear. Cervical CT revealed right parotiditis, and the patient was discharged with analgesia. Three days later, he returned to the ED due to the emergence of right conjuntivitis and a rash, with multiple plaque-like erosive lesions dispersed throughout the face, neck and upper limbs. The cutaneous lesions were painful, some of them with signs of bacterial infection especially on the palpebrae and ear pavilions. Ophtalmoscopic examination of the right eye showed signs of keratoconjuntivitis with small branching epithelial dendrites on the surface of the cornea. The patient was admitted in the Infectious Diseases department with suspected diagnosis of ec- zema herpeticum with bacterial superinfection, and started treat- ment with intravenous acyclovir and amoxicilin-clavulanate. The diagnosis was confirmed with the molecular detection of Herpes simplex type 1 virus on a skin swab. Both ocular and cuta- neous lesions progressively improved. The patient fullfield 7 days of endovenous antiviral and antibacterial, and then switched to oral acyclovir in order to complete 14 days of treatment. At discharge, the erosive lesions were all cleared, and only desquamative erythema remained (that was medicated with topic corticosteroids by Dermatology).
机译：28岁的男性患者被诊断出患有特应性皮炎，自完早用局部免疫抑制剂（Clobetasol丙酸酯和Pimecromus）。在急诊部门（ED）中呈现出急诊部门的痛苦和肿胀，延伸到同侧耳朵的一天痛苦和肿胀。宫颈CT揭示了右腮腺炎，患者用镇痛排放。三天后，他因右侧连翘炎和皮疹出现而返回eD，多种斑块状的腐蚀病变分散在整个脸部，颈部和上肢。皮肤病变是痛苦的，其中一些患有细菌感染的迹象，尤其是在蠕动和耳亭上。右眼的眼镜镜检查显示角膜内上皮树枝状胬肉的角膜外节炎症状。患者在感染性疾病部门被疑似诊断细菌超育，并开始治疗静脉注射Acyclovir和阿莫西林 - 克拉瓜酸盐。通过在皮肤拭子上的单纯疱疹1型病毒的分子检测确认了诊断。眼镜和切割病变均逐渐改善。患者全场7天的统治抗病毒和抗菌，然后切换到口服Acyclovir以完成14天的治疗。在放电时，侵蚀性病变都清除，只剩下脱皮红斑（用皮肤科用主题皮质类固醇药物药物）。

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