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Kaposi's varicelliform eruption in mycosis fungoides.

Kaposi's varicelliform eruption, caused by herpes simplex type 1, developed in a patient with mycosis fungoides four days after initiation of photochemotherapy with methoxsalen plus long-wave ultraviolet light (PUVA). He had a history of recurrent localized herpes infection. Vidarabine (adenine arabinoside) was used as treatment. Rechallenge with PUVA did not provoke another herpes infection. Kaposi's varicelliform eruption is rare in mycosis fungoides. Vidarabine may prove to be useful in the treatment of widespread herpes simplex.

Humans

Darier's disease and Kaposi's varicelliform eruption.

Kapos's varicelliform eruption usually occurs in persons with active skin disease of various types; however, in atopic dermatitis the condition may occur when the underlying disease is inactive. Two cases of widespread herpes simplex infection associated with Darier's disease are reported. In both cases, infection occurred in the absence of preexisting Darier skin lesions. In one case there was no previous history of Darier's disease. The infection occurred in the third trimester of pregnancy, but it did not appear to affect the infant or the placenta. In the second case, the Darier's disease was in remission at the time of onset of the virus infection.

Adult

Eczema herpeticum caused by herpesvirus type 2. A case in a patient with Darier disease.

This, to our knowledge, is the first documented report of eczema herpeticum due to infection with herpesvirus hominis type 2. The virus was isolated from a patient with known Darier disease who developed Kaposi varicelliform eruption. Recent increases in the incidence of infection with type 2 herpes simplex as well as the high frequency of recurrence with this virus make this infection of potential significance in patients with preexisting cutaneous disease.

Adult

Eczema herpeticum. Treatment with methylene blue and light.

Kaposi varicelliform eruption due to herpes simplex virus (eczema herpeticum) is a serious disease in infants, with occasional fatal outcome. Photoinactivation therapy consisting of local application of methylene blue followed by light exposure resulted in rapid improvement both clinically and virologically. Methylene blue, at a concentration of 10(-5)M was found to be viricidal to herpesvirus in the light but not in the dark.

Administration, Topical

Cutaneous dissemination of herpes simplex virus in individuals fifteen years of age and older.

We have reported the case histories of two individuals with underlying atopic dermatitis who developed extensive vesicular eruptions. In both cases herpes simplex virus type l was isolated from skin lesions and both individuals ultimately recovered. These two cases represent only the third and fourth instances of this syndrome proven to be caused by herpes simplex virus type l that have been reported in older individuals. In addition we have reviewed the literature relative to cutaneous disseminated herpes simplex virus infections occurring in individuals over the age of 15 and have presented a comprehensive overview of this disease.

Adolescent

Eczema herpeticum: atopic dermatitis complicated by primary herpetic gingivostomatitis.

Various aspects of eczema herpeticum are discussed, and a case of eczema herpeticum secondary to atopic dermatitis complicated by primary herpetic gingivostomatitis in a young adult is presented. The lesions cleared, and the patient was discharged after treatment via a multiphasic approach directed at the management of pyrexia, prevention of secondary bacterial infections, symptomatic and supportive care for the effects of the viral infection, and close monitoring for evidence of visceral viremia.

Adolescent

Atopic dermatitis.

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Administration, Topical

Widespread eczema vaccinatum acquired by contacts. A report of an autopsy case.

A 4-month-old male infant predisposed to allergic dermatitis acquired wide-spread eczema vaccinatum by contacts with a recently vaccinated sibling. He died of acute purulent peritonitis following a perforation of multiple duodenal ulcers. Fluorescence immunocytochemical and electron microscopic studies on the skin lesions revealed the presence of viral antigens and numerous virus particles compatible morphologically with those of the mature form from the same batch of smallpox vaccine given to the sibling. A large number of virus particles in the developmental form were also predominantly scattered in the cytoplasm of cells at the stratum malpighii of the epidermis as well as in neutrophils and macrophages in the skin lesions. The virus isolation from the skin lesions was done by using the HeLa cells and the human embryonic lung fibroblasts. No abnormal laboratory data were noted in immunoglobulins. On the basis of atrophy of the thymus and other lymphatic tissues and an appearance of large pyroninophilic cells in association with blastoid transformation, the authors discussed a possible participation of the disturbance of cellular immunity secondary to the virus infection in the development of the disease.

Antigens, Viral

Continuing mortality and morbidity from smallpox vaccination.

Three cases of cross-infection after smallpox vaccination are described, in two of which the outcome was fatal. Probably all occurred because simple precautions were not observed at the time of vaccination--for example, exclusion of contraindications and warnings about risks. If those countries still requiring evidence of vaccination for entry were to abolish this rule, however, the risk of cross-infection could be eliminated. Vaccinating a person with contraindications is justified only when exposure to smallpox has occurred.

Adult

Darier's disease: an immunologic study.

Darier's disease is frequently complicated by bacterial skin infections and occasionally by Kaposi's varicelliform eruption. Postulating that defective host immunologic competence might explain these infections, humoral and cell-mediated immunity (CMI) were evaluated in four patients. Humoral immunity was normal as demonstrated by quantitative immunoglobulins, isohemagglutinins, direct skin immunofluorescence, and B-cell counts. The CMI was evaluated by standard delayed type hypersensitivity skin tests, T-cell counts, lymphocyte transformation assays, macrophage inhibition factor (MIF) assays, and skin windows. Blunted lymphocyte blastogenesis, MIF, and skin window response indicated depressed CMI. Polymorphonuclear leukocyte chemotaxis and phagocytosis were normal.

Adolescent

[Participation of vaccinia virus in the pathogenesis of different clinical forms of postvaccinal complications. I. Frequency of vaccinia virus detection in the vaccinted who have usual and complicated reactions to vaccination].

The virological examination of 1365 samples taken from 469 children vaccinated against smallpox revealed considerable differences in the frequency and the time of vaccinia virus detection in different clinical forms of postvaccinal pathology as compared with uncomplicated vaccinal process. During the postvaccinal period taking its normal course vaccinia virus was isolated from 7.3% of children only from the pharynx till day 8 following vaccination. In generalized and creeping vaccinia the virus was isolated from 71.4% of children, in postvaccinal encephalitis from 57.1% of children, in vaccinal angina frove-mentioned complications vaccinia virus was detected in the samples obtained from the patients till days 24, 35, 15 and 24 respectively. The etiopathogenetic role of vaccinia virus in a number of postvaccinal complications is discussed.

Child, Preschool