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Atopic Dermatitis: Infected - Eczema Coxsackium

  • Rapid spreading of painful vesicles quickly turning into erosions. 
  • Typically in areas of previous eczema involvement.
  • Often follows seasonal presentations.
  • Associated features: 
    • Perioral vesicles and crusted papules, 
    • Erosions on palate,
    • Deep vesicles on palms and soles, 
    • Crusted papules and vesicles on buttocks and arms/legs.   
  • Fever may be present.  
  • May exhibit irritability or fatigue.   
  • Cough or rhinorrhea may precede skin involvement. 
  • Possible history of previous hand-foot-and-mouth disease exposure. 
  • Evaluate for possible mouth lesions (herpangina). 

*Note: Erosions are not as deep as seen with HSV/eczema herpeticum. 

Examples follow:

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These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.

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