Increased complications with Atopic Dermatitis and Varicella-Zoster virus

Abstract

A retrospective case note analysis and telephone consultation of 79 children, discharged from our teaching hospital with varicella zoster virus infection between 2003 and 2010, was performed. The hypothesis was that children with atopic dermatitis were more at risk of skin complications than children without. It was found that children with atopic dermatitis were significantly more likely to have varicella zoster virus infection complicated by cellulitis (21% versus 6%; p=0.05), haemorrhagic varicella (14% versus 2%; p=0.04) and superimposed ‘skin and soft tissue infection’ (61% versus 34%; p=0.008). Subjective severity of scarring was scored significantly higher in children with atopic dermatitis compared to those without (p = 0.006). In conclusion, skin related complications of varicella zoster virus infection are significantly more common in children with atopic dermatitis. Inclusion of atopic dermatitis as a “special case” in childhood vaccination programmes may prevent these complications. This warrants further more objective evaluation in a prospective study.