title: Herpetic infection in epidermolysis bullosa.
abstract: Patients with various forms of epidermolysis bullosa have fragile skin which can act as a breeding ground for multiple microbial agents. Standard wound care practices advocate the use of special dressings on open erosions as well as antibiotic topical medications to treat and prevent cutaneous infections. We report a child with recessive dystrophic epidermolysis bullosa admitted to our institution because of fevers at home. She was treated with multiple antibiotics for a cutaneous infection of the right hand. During her hospital stay, she sustained persistent fevers, and oral erosions developed, with progressive hemorrhagic crusting. Viral culture of the lip grew herpes simplex virus type 1, consistent with a diagnosis of herpetic gingivostomatitis. We present this patient to illustrate the importance of investigating wounds of epidermolysis bullosa patients for viral agents when faced with managing a child with an unclear source of fever. To the best of our knowledge, although this is the first report of herpetic gingivostomatitis in association with epidermolysis bullosa, it is likely to be more prevalent than the literature could suggest.
authors.affiliation: Department of Dermatology, Columbia University, New York, New York 10032, USA.
authors.forename: Adam I
authors.initials: AI
authors.lastname: Rubin
authors.forename: Maria C
authors.initials: MC
authors.lastname: Garzon
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Morel
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004820:Epidermolysis Bullosa / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006561:Herpes Simplex / Q000175:diagnosis*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D000212:Acyclovir