The patient was a 27-year-old man with moderate-to-severe atopic dermatitis since childhood, currently on treatment with topical corticosteroids. He came to the emergency department with a 2-day history of a diffuse pruritic rash. He reported no other symptoms suggestive of systemic involvement. Physical examination revealed multiple vesicular lesions, some with superficial erosions and scabs, affecting almost the whole body surface (Figs. 1 and 2). On a suspicion of eczema herpeticum, he was prescribed acyclovir 200mg every 4hours plus cloxacillin 500mg every 6hours for 7 days. Culture and polymerase chain reaction were positive for herpes simplex type1, confirming the suspected diagnosis. Three days later, the lesions were resolving.

Figure 1

(0.09MB).

Figure 2

(0.05MB).

Kaposi varicelliform eruption is a rare, severe, disseminated form of herpes simplex. It typically affects children and young adults between 20 and 29 years of age with a history of skin disease, particularly atopic dermatitis, though it has also been described in Darier disease, ichthyosis vulgaris, pemphigus, mycosis fungoides, histiocytosis, and seborrheic dermatitis.