BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39583.477442.BE (Published 22 May 2008) Cite this as: BMJ 2008;336:1198
  1. V Samarasinghe, specialist registrar,
  2. S Varma, consultant
  1. 1department of dermatology, Queen’s Medical Centre, Nottingham NG7 2UH
  1. venuras1{at}hotmail.com

    A 16 year old girl with a history of atopic eczema developed multiple, punched out, painful erosions over her forehead and eyelids after exposure to a person with active cold sores. This “shotgun blast” appearance is typical of eczema herpeticum caused by herpes simplex and resolved rapidly with oral acyclovir. Patients with atopic eczema are susceptible to viral infections. Delay in treatment may contribute to scarring of skin and eyes and may be life threatening in a child. Patients with atopic dermatitis should be told to avoid close contact with people who have active cold sores.


    • Patient consent obtained.

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