| Abstract: | Three atopic siblings with sequential primary herpes simplex virus (HSV) infection on their eczematous lesions following their father's recurrent herpes labialis were presented. Eczema herpeticum was diagnosed on the basis of their characteristic grouped umbilicated vesicles superimposed on pre-existing atopic eczematous lesions. HSV type 1 was identified from the three patients' Tzanck smears and viral isolation of vesicular contents by monoclonal antibodies. The skin lesions faded spontaneously in the first case, although this elder brother did not receive any antiviral treatment. Later, he developed mild recurrence of skin lesions on his extremities. His younger twin sisters were treated with systemic acyclovir and no recurrences occurred during 2 years of follow up. All of them developed anti-HSV antibody about 7 to 14 days after clinical onset. Acyclovir seems to be an effective antiviral agent in treating eczema herpeticum and reducing subsequent recurrences after primary herpes simplex virus infection. |
