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JACI Highlights - August 2009

What is unique about atopic dermatitis subjects who get eczema herpeticum?

A subset of atopic dermatitis (AD) subjects are at increased risk for certain viral infections. The condition called eczema herpeticum (EH), caused by a serious and extensive skin infection with the herpes simplex virus, was the focus of a National Institute of Allergy and Infectious Diseases-funded study reported in the August 2009 issue of The Journal of Allergy & Clinical Immunology by Beck et al.

The authors established a registry of more than 900 cases (including AD subjects with and subjects without a history of eczema herpeticum [ADEH+ and ADEH–, respectively], as well as healthy controls). They found that ADEH+ subjects have more severe skin disease, an earlier age of onset, more frequent history of other allergic disorders such as asthma or food allergy, and immunologic indicators suggestive of a more atopic predisposition. The herpes simplex virus-susceptible group (ADEH+) was more commonly sensitized to allergens, especially perennial and food allergens. ADEH+ individuals had skin infections with Staphylococcus aureus and appeared to be more susceptible to skin infections with other microbes than subjects without a history of EH (ADEH–).

Further studies are underway to identify biomarkers or genetic signatures that will identify the AD subjects at risk for these severe skin infections.

“Phenotype of Atopic Dermatitis Subjects with a History of Eczema Herpeticum” by Beck et al.(JACI August 2009 Volume 124 No. 2).

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