Kaposi varicelliform eruption in patients with Darier disease: A 20-year retrospective study

BackgroundKaposi varicelliform eruption (KVE), or herpes simplex virus (HSV) superinfection of pre-existing skin lesions, may complicate Darier disease.ObjectiveWe sought to compare the clinical features and outcomes of patients with Darier disease who developed KVE superinfection with those who did not.MethodsA 20-year retrospective analysis of 79 patients with Darier disease treated at our institution was performed.ResultsEleven (14%) patients developed KVE, of whom 45% required hospitalization for their skin disease during the follow-up period. Patients with KVE had more severe Darier disease (P = .030) and were more likely to be hospitalized (P = .015). HSV was detected in erosions without concomitant vesicles or pustules in 64% of confirmed cases. In all, 23 (55%) patients with erosions had HSV testing pursued.LimitationsRetrospective study design is a limitation.ConclusionThe majority of KVE occurs in painless or painful erosions that may also appear impetiginized without vesicle or pustule formation. As HSV superinfection is correlated with severe Darier disease and risk for hospitalization, increased recognition of this phenomenon may lead to better patient outcomes.