Exacerbation of severe atopic dermatitis

We are talking about our patient, who had an exacerbation of severe atopic dermatitis during a vacation at sea.

Shortly before her departure, she developed cold sores on her lips. Upon arrival at the sea, the temperature rose, chills and headaches appeared. Multiple small grouped rashes appeared on the chest and neck. The patient could not sleep, any movement of the head and touching the rash caused pain.

She sought online advice from Dr. Yuri Khaliulin and sent him a photo of the rash. The doctor assessed the complication of atopic dermatitis as localized Kaposi's eczema herpetiforme, and suggested hospitalization at the place of rest, or treatment: injection of a long-acting corticosteroid, high-dose valacyclovir and antihistamines, topically with an antiseptic solution.

The patient contacted a local doctor with these recommendations and began treatment. His general condition improved, and his temperature returned to normal.

The patient returned to Moscow 2 days after the online treatment and immediately came to the EMS. Upon examination, no new rashes were found. We conducted an examination that included a general blood test with ESR, blood biochemistry, and antibodies to the herpes virus. The level of antibodies against the herpes simplex virus of the first type turned out to be very high. The rest of the indicators are normal. The results confirmed the correctness of the remotely established diagnosis and the prescribed treatment.

The patient's condition improved significantly, and 7 days after the online consultation, her skin condition returned to normal.

The patient made the right decision in this case. Instead of self-medication, she used an online consultation through the EMC mobile app. Improper treatment could have worsened the situation. For example, the use of corticosteroids without an antiviral drug could lead to the spread of herpes infection up to life-threatening herpetic sepsis. Antiherpetic treatment without corticosteroids would not have stopped the exacerbation of atopic dermatitis, the disease could progress and affect the entire skin surface. The remote consultation helped to avoid many problems.