Abstract
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.

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