a 22-year - old gravida two para one woman in her 23 week of pregnancy presented with a painful papular eruption on her face and neck of one week 's duration . she denied history of sick contacts , sun exposure , or sexually transmitted diseases . on examination , her temperature was 37.8c , heart rate 120 beats per minute , and blood pressure 127/72 mmhg . there were multiple hyperpigmented plaque - like lesions covering 80% of her body surface , and tender umbilicated vesiculo - papular lesions on her face , neck and upper torso in different stages of development . her fundal height was appropriate for stated length of pregnancy and gynecological examination was unremarkable . intravenous acyclovir 5 mg / kg per dose three times daily and intravenous cefazolin one gram every six hours were administered . , no new lesions were noted , and herpetic rash cleared by tenth day of therapy . subsequently , viral and bacterial cultures from lesions isolated hsv-1 and methicillin sensitive staphylococcus aureus , which was also present in her bloodstream . kaposi in 1887 , eh is a disseminated herpetic infection of inflamed skin that may complicate ad , darier - white disease , pemphigus foliaceus , mycosis fungoides , sezary syndrome , ichthyosis vulgaris , and burns . several theories have been proposed to explain pathogenesis of eh , including decreased skin integrity , impaired plasmacytoid dendritic cell recruitment and local interferon production . associated findings may include fever , malaise , lymphadenopathy , elevated serum ige levels , and relative lymphopenia . failure of early recognition and prompt treatment with intravenous acyclovir and concomitant antibiotics may carry risk of multiorgan failure and death . use of corticostroids has not been shown to cause eh , and treatment of the underlying ad is warranted . overall , ehg is rare but serious condition that may complicate pregnancy in patients with ad and requires prompt recognition .
eczema herpeticum ( eh ) , or kaposi 's varicelliform eruption , is a skin infection with herpes simplex type i virus ( hsv-1 ) that occurs in patients with compromised skin integrity , such as atopic dermatitis ( ad ) . 
 unrecognized , it may be fatal and viremia in pregnancy may lead to fetal demise and miscarriage . 
 we describe a rare case of eh in pregnancy , eczema herpeticum gravidarum ( ehg ) , which is the third published report in the literature to date .