Relationship Between the Presence of Eczema Herpeticum and the Significance of Clinical and Laboratory Tests in Korean Children With Atopic Dermatitis

BACKGROUND Eczema herpeticum (EH) is a herpes simplex virus (HSV) infection superimposed on atopic dermatitis (AD). OBJECTIVES The aim of this study was to evaluate the relationship between clinical features and laboratory tests, including skin cultures, total IgE, eosinophil count, eosinophil cationic protein, and 25-hydroxyvitamin D3 (25-(OH)D3), in Korean children with AD according to the presence of EH. PATIENTS AND METHODS We enrolled 380 patients aged 6 months to 18 years who were admitted to Busan St. Mary's hospital from January 2012 to December 2014. All 380 subjects were divided into two groups: the control and the AD group. The AD group was further divided into two subgroups: EH+ and EH-. RESULTS The male gender was related to the presence of EH (odds ratio of 2.56; 95% confidence interval, 1.19 - 5.53, P = 0.01), but age and 25-(OH)D3 levels were not. After adjusting for age, gender, and 25-(OH)D3, no significant relationship was found between total IgE, eosinophil cationic protein or eosinophil count levels and the presence of EH. The relationship between positive skin cultures and the presence of EH was significant (P < 0.001) and the presence of methicillin-resistant Staphylococcus aureus (MRSA) was also related to the development of EH (OR, 0.19; 95% CI, 0.04 - 0.92, P = 0.03). CONCLUSIONS We conclude that while male gender, positive skin culture results, and the presence of MRSA are factors influencing EH, serum 25-(OH)D3 levels are not associated with EH in Korean AD children.