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Eczema herpeticatum is well known as a complication associated with atopic dermatitis. We previously reported 2 cases that developed in adult patients during treatment of their atopic dermatitis with tacrolimus ointment.¹ In a 1-year open study in adult patients with atopic dermatitis who were treated with tacrolimus ointment, eczema herpeticatum was observed at low frequencies (1.8%), but the data were insufficient to establish a causal relationship.² Nevertheless, prevention is important, as the complication is potentially serious and may compromise a promising treatment alternative in a patient with atopic dermatitis.

Preventive recommendations against infectious complications due to herpes simplex virus during treatment with tacrolimus ointment have been limited to the common sense advice to interrupt the treatment until bacterial or viral infections have cleared.³ This strategy primarily concerns patients with recognized symptomatic infection, ie, individuals who know about the symptoms and aspect of their recrudescent herpes simplex lesions and therefore may . . . [Full Text of this Article]

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