Atopic Dermatitis as a Risk Factor of Herpes Simplex Virus Type 1 Reactivation: a Case Report

Andi A. M. Putri(1), Anandina I. Soegyanto(2),

(1) Department of Oral Medicine, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia


Objective Atopic Dermatitis (AD) is a recurrent chronic inflammatory skin disease that causes skin barrier defects and improper immunologic responses. This disease has high possibility to develop infections and reactivation of latent viruses, such as HSV-1 reactivation. This case report will review the potency of AD as a risk factor of orofacial HSV-1 reactivation.

Method: A 43 years-old female came to Universitas Indonesia dental hospital with painful mouth ulcers. She felt weak, dizzy, and feverish for a week, with history of allergies which also runs in her family. Clinical examination showed multiple erosion on her face, hands, and legs; crust on the right lower vermillion border; multiple ulcers on the lower labial, right buccal and palate mucosa, with erythema on the anterior tongue. The patient was diagnosed with recurrent orofacial herpes and treated with topical acyclovir 5% cream, chlorhexidine gluconate 0.2% mouthrinse, and a multivitamin. Her skin lesion has been discussed with a dermatologist and diagnosed as AD.

ResultsA week after therapy, all oral lesion was improved and totally disappeared after several weeks. Atopic dermatitis is a recurrent chronic inflammatory skin disease that can significantly affect the quality of life. Therefore, the skin barrier defect and the decrease of immune systems contribute to the increased susceptibility to recurrent HSV infections.

Conclusion: Atopic dermatitis may be a risk factor for HSV-1 reactivation, including recurrent orofacial herpes.


recurrent orofacial herpes, atopic dermatitis, HSV reactivation

Full Text:



Balasubramaniam R, Kuperstein AS. Update on oral herpes virus infections. Dent Clin N Am. 2014;58:265-80.

Stowe RP, Peek MK, Cutchin MP, Goodwin JS. Reactivation of herpes simplex virus type 1 is associated with cytomegalovirus and age. J Med Virol. 2012;84:1797-802.

Hupp WS. Diseases of the Mouth. Vol 15. 1st ed. Elsevier Ltd.; 2014;952-3.

Conrady CD, Drevets DA, Carr DJJ. Herpes simplex type I (HSV-1) infection of the nervous system : is an immune response a good thing ?. J Neuroimmunol. 2010;220:1-9.

Fatahzadeh M, Schwartz RA. Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol. 2007;57:737-63.

Ramchandani M, Kong M, Tronstein E, et al. Herpes simplex virus type 1 shedding in tears, and nasal and oral mucosa of healthy adults. Sex Transm Dis. 2008;54:756-60.

Flohr C, Pascoe D, Williams HC. Atopic dermatitis and the ‘hygiene hypothesis’: too clean to be true ? Br J Dermatol. 2005:202-16.

Azodo CC, Umoh AO. Herpes labialis among dental healthcare providers in Nigeria. ijdentistry. 2015;6(3):116-20.

Pandaleke TA, Pandaleke HEJ. Etiopatogenesis dermatitis atopi. JBM. 2014;6(2):76-83.

Marcdante KJ, Robert M. Kliegman. Atopic dermatitis. In: Nelson Essentials of Pediatric; 2018:325-8.

Wollenberg A, Wetzel S, Burgdorf WH, Haas J. Viral infections in atopic dermatitis: pathogenic aspects and clinical management. J Allergy Clin Immunol. 2003;112:667-74.

Arduino PG, Porter SR. Oral and perioral herpes simplex virus type 1 (HSV-1) infection: review of its management. Oral Dis. 2006;12:254-70.

Avci O, Ertam I. Viral infections of the face. Clin Dermatol. 2014;32:715-33.

Opstelten W, Neven AK, Eekhof J. Treatment and prevention of herpes labialis. Can Fam Physician. 2008;54:1683-7.

Dangore Khasbage S. Recurrent herpes labialis during pregnancy: a case report. Oral Heal case Rep. 2017;3(1):131-3.

Sun D, Ong PY. Infectious complications in atopic dermatitis. Immunol Allergy Clin N Am. 2017;37:75-93.

James WD, Elston DM, McMahon PJ. Atopic dermatitis, eczema, and noninfectious immunodeficiency disorders. In: Andrews’ Diseases of the Skin. Philadelphia: Elsevier; 2016. p. 62-89.

Boguniewicz M, Leung DYM. Recent insights into atopic dermatitis and implications for management of infectious complications. J Allergy Clin Immunol. 2018;125(1):4-13.

Chida Y, Mao X. Does psychosocial stress predict symptomatic herpes simplex virus recurrence ? a meta-analytic investigation on prospective studies. Brain Behav Immun. 2009;23(7):917-25.

Shah S, M PD, SV R, Tyagi K, Singh D. Primary herpetic gingivostomatitis: a case report and review of literature. TMU J Dent. 2014;1(3):119-24.






  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License. View My Stats