Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about Exma Hepaticum. And you can find written notes on this topic at zero definals.com

slash exma herpeticum or in the dermatology section of the zero definals pediatrics book.

So let's get straight into it.

Exma herpeticum is a viral skin infection caused by the herpesimplex virus or HSV

or the varicella zoster virus or VZV.

It was previously known as Kaposi-Varicelliform eruption. But don't confuse this with

Kaposi sarcoma, which occurs in late stage HIV infection. Herpes simplex virus 1, or HSV1,

is the most common causative organism and it may be associated with a cold sore in the patient

or a close contact. It usually occurs in patients with a pre-existing skin condition such as

atopic eczema or dermatitis, where the virus is able to enter the skin and cause an infection.

Let's talk about the presentation.

The typical presentation is a patient who suffers with eczema that has developed a widespread,

painful, vesicular rash with systemic symptoms such as fever, lethargy, irritability and reduced

oral intake.

There will usually be lymphadenopathy, which is swollen lymph glands.

Let's talk about the rash.

The rash is usually widespread and can affect any area of the body.

It's erythematous, painful and sometimes itchy,

with vesicles which are fluid-filled lumps on the skin.

These vesicles contain pus.

After the vesicles burst, they leave small, punched-out ulcers with a red base.

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