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What are the chances of getting "eczema herpeticum" as a…

what are the chances of...
what are the chances of getting "eczema herpeticum" as a complication of herpetic willow?Would touching anything with hands that are infected with the herpetic willow, could transfer the virus there? In other words how contagious and self-contagious is herpetic willow?
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Answered in 13 minutes by:
1/17/2017
Dr. Captain
Dr. Captain, Dermatologist
Category: Dermatology
Satisfied Customers: 782
Experience: A family doctor, with medical and residency training in Boston, MA, patients of all ages and wide range of illnesses.
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Eczema herpeticum is quite common to have as a complication. The virus transfers with physical contact, whenever the virus is shedding.

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One could argue that a single vesicle with herpes could (and often does) infect the contiguous skin, which, if itself develops more vesicles, could be called eczema herpeticum. If you're asking if herpetic eczema is common, in general, with those patients who have episodes of Whitlow, the answer is "no" this is not common at all. Most cases of whitlow are focal, regional, and limited. They do not spread like wildfire to other regions of the body, or to others.

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Customer reply replied 1 year ago
But how common is the Hepatic Whitlow itself? I read 3 per 100k which would be Like 900 cases for the entire US? That would be quite rare, no?Comparing to 3 million cases of cold sores per year, that's like less than one in 3000 people with cold sores will develop hepatic willow.Or would you say that Hepatic Willow is more common than that?My concern is that I have a particular virulent strain that may progress into meningitis etc... Or do you think it's less to do with virulence of the strain but with the following:(1) I had shedding cold sores
(2) I touched and ripped them with my hands
(3) My hands had cracks from Eczema
(4) I was overusing potent steroid creams by over-applying them for prolong periods of times which resulted in(a) thining of skin
(b) local (?) supression of immune systemSo the above confluence of factors created a "perfect storm" for the opportunistic herpes virus.

It is pretty uncommon - I would say more common than those statistics you're quoting... but I don't pretend to know the precise epidemiology. The part you're leaving out is that, barring rare concerns you haven't mentioned to me, you have a healthy immune system that is on your side, protecting you!

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Customer reply replied 1 year ago
Yeah that's what I think immune system is a strong factor. So is true that applying grams of diproprionate sterois per day could weaken it locally and allow the virus to break in? And it's a good idea to stop using steroids, especially since it appears that theraplex emollient I just start using appears to work as well or better as any steroid I tried (https://nationaleczema.org/eczema-products/moisturizers/theraplex/)

i would say, for the time being, take a break from the steroid creams... fine to continue using emollients...

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Customer reply replied 1 year ago
Thank you for your advise and your time!

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Dr. Captain
Dr. Captain, Dermatologist
Category: Dermatology
Satisfied Customers: 782
Experience: A family doctor, with medical and residency training in Boston, MA, patients of all ages and wide range of illnesses.
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