Coxsackievirus A6 associated with eczema exacerbation in children

Eczema (atopic dermatitis) exacerbation is one of the most common presentations seen in the paediatric population. Recently, eczema exacerbations due to enteroviral infections have become increasingly prevalent. Enterovirus infection is commonly associated with hand, foot, and mouth disease, and the virus can cause a similar presentation in eczema patients. Coxsackievirus type A6, an enterovirus subtype, has been implicated in severe cutaneous eruptions. Recent outbreaks have been documented in Asia, Europe, America and New Zealand.
In May to July 2014, 11 patients with atypical exacerbations of eczema were identified in a tertiary dermatology centre in Melbourne, Australia. Skin swab samples, analysed by polymerase chain reaction, were positive for enterovirus for all 11 cases. 5 cases underwent further viral subtyping, and were positive for coxsackievirus A6. A variety of clinical presentations were observed, including severe cutaneous hand foot and mouth disease and eczema coxsackium. This study confirms the presence of coxsackievirus A6 as an important infective cause of eczema exacerbation in Australia.

Dr. Alexander Gin