Akinori Amatsu

Detection of Herpes simplex Virus DNA in Non-Herpetic Areas of Patients with Eczema herpeticum

Background: Patients with atopic dermatitis may develop a widespread cutaneous herpes simplex virus (HSV) infection called eczema herpeticum. Objective: We examined the possible routes of indirect HSV dissemination in 10 patients with eczema herpeticum, although direct spread of HSV is the most likely route of infection. Methods: Specimens were collected from hands and ‘non-herpetic’ areas (i.e. without eczema herpeticum), with or without eczematous and/or erythematous lesions of atopic dermatitis, of 10 patients with eczema herpeticum. We tried to detect HSV DNA in the samples by polymerase chain reaction. Results: HSV DNA was frequently detected on both hands and on cutaneous surfaces clinically free of eczema herpeticum. These patients had scratched such lesions because of itching. Moreover, they had taken baths the day before the examination. Conclusion: These results suggest that there may be two routes of indirect transmission of this virus, namely via manual scratching of herpetic lesions or via a contaminated bath towel or item of underwear.

Dermoscopic features in a case of dyschromatosis symmetrica hereditaria

Usingdermoscopy, we found extraordinary features, whichhad not been described previously.A 24-year-old Japanese man presented with apersistent pigment anomaly. Physical examinationrevealed a mixture of oval or round, hyperpigmentedand pigmented spots 1–7 mm in diameter and irregu-larly shaped hypopigmented macules on the dorsalhands and feet (Fig. 1a). On the face, he had small,freckle-like hyperpigmented spots. The consanguini-ties had no such pigmentations. To verify the diagno-sis precisely, a genetic study was performed asdescribed previously.

Pigmentary mosaicism with hyperpigmented streaks on the palmoplantar lesion associated with balanced X; autosome translocations t(X; 9)(p11.21; q34.1)

© 2008 The Authors JEADV 2009, 23, 317–368 Journal compilation

Spotted hyperpigmentation: disfigured melanosomes in melanocytes and keratinocytes

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High Frequency of Detection of Herpes simplex Virus DNA in the Oral Cavity of Patients with Eczema herpeticum

Background: It has been reported that herpes simplex virus (HSV) DNA was detected in the oral cavity of patients with herpes labialis under various conditions such as during oral surgery. Objective: The frequency of detection of oral HSV DNA was compared between first or recurrent episodes of eczema herpeticum and recurrent type herpes labialis. Patients and Methods: Oral swabs were collected from 7 patients with eczema herpeticum and 9 with herpes labialis. The detection of oral HSV DNA was performed by the polymerase chain reaction method. Results: Oral HSV DNA was detected in 6 out of 7 patients (86%) with eczema herpeticum and 3 of 9 (33%) with herpes labialis. Conclusions: The high frequency of oral HSV DNA detection in eczema herpeticum suggests that subclinical herpetic lesions may develop in the oral cavity of patients with a first episode of eczema herpeticum or may occur during asymptomatic oral HSV shedding in people with recurrent eczema herpeticum.