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Findings Bank
A Eczema Herpeticum (HSV)
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B Bacterial Impetigo
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C Stevens-Johnson Syndrome
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Infectious Complications of Atopic Dermatitis Cheatsheet
Key Concept: Eczema herpeticum = HSV superinfection of atopic skin → PUNCHED-OUT erosions + hemorrhagic crusting. Treatment is systemic ACYCLOVIR, not antibiotics. Do not confuse with bacterial impetigo (honey-colored crusts).
Diagnosis
Key Features
Eczema Herpeticum (HSV)
'Punched-out' erosions with hemorrhagic crusting
Fever, irritability, tender lymphadenopathy
Background of atopic dermatitis (impaired skin barrier)
Caused by HSV-1; risk of visceral dissemination (hepatitis, encephalitis)
Treatment: systemic acyclovir or valacyclovir (URGENT)
NOT treated with antibiotics (penicillin, TMP-SMX)
Bacterial Impetigo
Honey-colored adherent crusts on erythematous base
Caused by S. aureus (most common) or Group A Strep
No hemorrhagic crusting; no punched-out erosions
Treatment: mupirocin (localized) or oral cephalexin/dicloxacillin
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