Herpes Simplex Virus as a Cause of Allergic Mucocutaneous Reactions (Ectodermosis Erosiva Pluriorificialis, Stevens–Johnson's Syndrome, Etc.) and Generalized Infection

Publisher Website
Google Scholar
Abstract
The experience gained concerning relations between recurrent herpes simplex affections and erythema exsudativum multiforme is first presented. Although a certain incidence of herpes virus was found in the eruptions, the histopathological and electron-optical investigations, in particular, as well as provocation through virus-free herpes antigen, indicate that the cutaneous lesions are to be regarded as an allergic reaction. In the present series of 122 cases of febrile mucocutaneous syndromes 7 cases of such allergic reactions are reported in conjunction with primary herpes stomatitis. The exanthemas were of varying type, as was the combination of mucous symptoms. The syndromes could thus be classified, from the most widespread, in the form of total pluriorificial ectodermosis, to the least widespread, Stevens–Johnson's syndrome, and intermediate forms. The herpes infection may, however, be generalized, as is the case in the newborn, in infants suffering from malnutrition and diseases with poor immunological defence, and in patients undergoing immunosuppressive treatment. The eighth patient in this series represented such a case of disseminated herpes in a young woman with L.E.D. treated with cortisone. She had severe stomatitis and a variola-like eruption from which herpes virus was isolated. Typical giant cells proved the existence of cellular changes of viral origin. It is remarkable that in two earlier published cases in adults the eruption was interpreted as variola. Allergic cutaneous and mucous manifestations may thus occur in acute herpes infections. This should support the view that eruptions of an allergic nature may follow after recurrent herpes affections. Generalized herpes, on the other hand, is likely to appear only under special circumstances, in particular under conditions of reduced immunological defence. When vesicular eruptions are present, the demonstration of giant cells enables us to distinguish between eruptions of specifically viral and of allergic origin.