At a glance: Impetigo versus eczema herpeticum

Eczema herpeticum
Eczema herpeticum


Discriminatory signs

  • Caused by bacteria Streptococcus pyogenes and/or Staphylococcus aureus. 
  • Usually affects children.  
  • Contagious.  
  • Often occurs on exposed areas such as the hands and face.  
  • Pustules and round, crusted, oozing patches which get bigger.  


  • If oozing, cover the affected areas, avoid close contact with others and keep the child away from school.  
  • Antibiotic ointment.  
  • Oral antibiotics.  
  • In resistant cases consider treating carrier sites or household contact who might be a carrier.       

Eczema herpeticum  

Discriminatory signs 

  • History of eczema.  
  • Exposure to a contact with recurrent Herpes simplex virus infection.  
  • Excoriated red, papules, vesicles and crusts.  
  • Small umbilicated vesicles.  
  • More painful than itchy.  
  • Systemically unwell.  
  • A potentially life-threatening superinfection which should be treated as a dermatologic emergency.  


  • Analgesia.  
  • Oral antiviral agents. 

Contributed by Dr Vasa Gnanapragasam, a GP in Sutton, Surrey

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