Expert
Reviews in Molecular Medicine: http://www.expertreviews.org/
DOI: 10.1017/S1462399408000756; 14 July 2008
Caroline
Bussmann, Wen-Ming Peng, Thomas Bieber and Natalija Novak (2008) Molecular pathogenesis
and clinical implications of eczema herpeticum. Expert Rev. Mol. Med. Vol. 10,
e21, DOI: 10.1017/S1462399408000756
Molecular pathogenesis
and clinical implications of eczema herpeticum
Caroline Bussmann a1,
Wen-Ming Peng a1, Thomas Bieber a1 and Natalija Novak
a1 c1
a1 Department
of Dermatology and Allergology, University of Bonn, Bonn, Germany.
c1 Corresponding
author: Natalija Novak, Department of Dermatology and Allergology, University
of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. Tel: +49 228 287 15370;
Fax: +49 228 287 14333; E-mail: Natalija.Novak@ukb.uni-bonn.de
A
subgroup of patients with atopic dermatitis develops one or more episodes of
a severe viral skin infection caused by herpes simplex virus superimposed on
eczematous skin lesions. This condition is named atopic dermatitis complicated
by eczema herpeticum. Characteristic features of patients developing eczema
herpeticum include an early age of onset of atopic dermatitis with a persistent
and severe course into adulthood, predilection for eczematous skin lesions in
the head and neck area, elevated total serum IgE levels and increased allergen
sensitisation. Deficiencies at the level of both the innate and the adaptive
immune system, which have been identified in atopic dermatitis, are much more
pronounced in this subgroup. Predisposing cellular factors include a reduced
number of plasmacytoid dendritic cells in the epidermis and a modified capacity
of these cells to produce type I interferons after allergen challenge. In addition,
lower levels of antimicrobial peptides in the skin of atopic dermatitis patients,
resulting in part from a Th2-prone micromilieu, contribute to the lack of an
effective defence against viral attack. In this review, we summarise the current
knowledge of the molecular pathogenesis of eczema herpeticum.
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