History of S. aureus Skin Infection Significantly Associates with History of Eczema Herpeticum in Patients with Atopic Dermatitis

• Published in: Dermatology and therapy Vol. 13; no. 10; pp. 2417 - 2429
• Main Authors: Moran, Mary C., Klose, Alanna, Yoshida, Takeshi, De Benedetto, Anna, Schneider, Lynda C., Ong, Peck Y., Simpson, Eric L., Leung, Donald Y. M., Miller, Benjamin L., Seplaki, Christopher L., Beck, Lisa A.
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01-10-2023; Springer; Adis, Springer Healthcare
• Subjects: Advertising executives; Atopic dermatitis; Bacterial skin diseases; Biotechnology industry; Brief Report; Care and treatment; Complications and side effects; Dermatology; Eczema; Eczema herpeticum; Health aspects; Herpes simplex; Immunoglobulin E; Immunoglobulin G; Immunoglobulins; Infection; Internal Medicine; International economic relations; Medicine; Medicine & Public Health; Oral and Maxillofacial Surgery; Papillomavirus infections; Pharmaceutical industry; Plastic Surgery; Quality of Life Research; Risk factors; S. aureus; Skin; Staphylococcus aureus; Staphylococcus aureus infections; Viral skin infections; United States; France; Viral skin infections; Immunoglobulins; Eczema herpeticum; Atopic dermatitis; S. aureus
• ISSN: 2193-8210; 2190-9172
• DOI: 10.1007/s13555-023-00996-y

Introduction
Patients with atopic dermatitis (AD) are uniquely susceptible to a number of serious viral skin complications, including eczema herpeticum (EH), caused by herpes simplex virus. This study explored the associations between biomarkers of epithelial barrier dysfunction, type 2 immunity,
Staphylococcus aureus
infection, and
S. aureus
-specific immunoglobulin responses in a cohort of AD subjects with and without a history of EH (EH+ and EH−, respectively).
Methods
A total of 112 subjects with AD (56 EH+, 56 EH−), matched by age and AD severity, were selected from a registry of over 3000 AD subjects. Logistic regression was used to test the association between history of
S. aureus
skin infection and history of EH, while controlling for a number of confounders.
Results
Compared to those without a history of
S. aureus
skin infection, subjects with a history of
S. aureus
skin infection were found to have more than sixfold increased odds of having a history of EH (6.60, 95% confidence interval [CI]: 2.00–21.83), after adjusting for history of other viral skin infections (molluscum contagiosum virus, human papillomavirus), serum total IgE, and IgG against the
S. aureus
virulence factor SE
l
X.
Conclusions
These findings indicate an important relationship between
S. aureus
skin infections and EH.