Psoriasis herpeticum: three cases of Kaposi's varicelliform eruption in psoriasis

Abstract

Background: Kaposi's varicelliform eruption (KVE), first described in 1887 by Moritz Kaposi, refers to a disseminated cutaneous infection with herpesvirus type 1 or 2, vaccinia virus, or coxsackievirus A16 in a patient with another underlying dermatosis. When herpesvirus type 1 or 2 is the pathogenic virus, the term "eczema herpeticum" is used, independent of the underlying dermatologic diagnosis that preceded the eruption. KVE is most often seen in patients with underlying atopic dermatitis, but has also been seen in association with other papulosquamous and acantholytic disorders. However, eczema herpeticum rarely occurs in patients with psoriasis.

Observations: We present the clinical and laboratory findings of three patients in whom KVE developed during inpatient hospitalization for a psoriatic flare. These patients each had comorbidities that may have increased susceptibility to KVE.

Conclusions: KVE may rarely occur in patients with psoriasis. Erythroderma, systemic sepsis, therapy with immunosuppressant drugs, such as methotrexate and systemic steroids, and therapy with systemic retinoids may possibly increase susceptibility to KVE.