Epidemiology of Eczema Herpeticum in Hospitalized U.S. Children: Analysis of a Nationwide Cohort

Derek Y. Hsu, Kanade Shinkai, Jonathan I. Silverberg*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Eczema herpeticum (EH) is characterized by viral infection of a preexisting inflammatory dermatosis and is associated with considerable morbidity. In this cross-sectional study, we sought to determine the incidence, risk factors, comorbidities, costs of care, length of stay, and mortality in hospitalized U.S. children with EH. The Nationwide Inpatient Sample 2002–2012, containing a 20% sample of all U.S. hospitalizations, was analyzed. We used a validated approach involving International Classification of Diseases, Ninth Revision–Clinical Modification codes to identify patients primarily admitted for EH (n = 4,655 weighted). The mean annual incidence of hospitalization for EH per million children ranged from 4.03 to 7.30, increasing significantly from 2008 to 2012. EH was associated with younger age (odds ratio [95% confidence interval] for 3–4 years = 1.29 [1.02–1.64]) and nonwhite race/ethnicity (black = 2.93 [2.35–3.66], Asian= 4.41 [3.34–5.83], Native American = 2.96 [1.51–5.78]) but was less likely to occur in areas with lower income quartiles (quartile 1, 0.66 [0.53–0.84]; quartile 2, = 0.68 [0.54–0.87]; quartile 3, 0.70 [0.56–0.88]). EH was associated with atopic dermatitis (11.72 [9.48–14.49]). Increased length of stay and costs of care were associated with Asian race. Mean length of stay was 3.86 ± 0.09 days, and mean cost of care was $5,237.6 ± 160.6. Overall mortality was 0.1%. EH in hospitalized children poses a substantial burden to the health care system.

Original languageEnglish (US)
Pages (from-to)265-272
Number of pages8
JournalJournal of Investigative Dermatology
Issue number2
StatePublished - Feb 2018

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology
  • Dermatology
  • Cell Biology


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