What is the main complication associated with eczema herpeticum?

The main complication associated with eczema herpeticum is secondary bacterial infection. Eczema herpeticum occurs when the herpes simplex virus infects an area of skin that is already affected by atopic dermatitis, leading to vesicular lesions. The damaged skin barrier in patients with eczema makes them more susceptible to infections. When the skin is compromised, it can allow for bacteria to penetrate and cause a secondary infection, which can be quite serious and lead to further complications such as cellulitis or abscess formation. This is particularly concerning in individuals with eczema, as their skin is often inflamed and not as resilient against pathogens.

In contrast, the other options presented do not directly relate to the complications arising from eczema herpeticum. Systemic lupus erythematosus is an autoimmune condition that is not caused by primary skin infections. Chronic dermatitis could result from chronic eczema but is not a direct complication of an active herpetic infection. Autoimmune reactions are also not seen as complications specific to eczema herpeticum, making secondary bacterial infection the most relevant risk in this scenario.