ABSTRACT
The boy has eczema herpeticum. Although eczema may present as a vesicular eruption on its own, it is the presence of clustering of vesicles with cropping and exacerbation of the underlying eczema that should prompt diagnosis. The severity is very variable,but in some instances the eruption may be widespread and associated with systemic features such as a high temperature. Specific antigen detection using ELISA or immunofluorescence techniques on scrapings from lesions can provide rapid diagnosis. Treatment with oral aciclovir is effective unless the condition is life-threatening or if the child is immunocompromised (e.g. is on systemic corticosteroids or cytotoxic therapy or has an immunodeficiency syndrome), when intravenous aciclovir should be started.
