(BMJ)—A 17-mo boy w/ atopic eczema developed a rash on his limbs, w/ a few oral lesions, over the course of 48h. Exam: febrile; otherwise well-appearing; papulovesicular rash on limbs. Swab from a lesion confirmed the dx. What is it?
Eczema coxsackium
Varicella
Kaposi varicelliform eruption
Bullous impetigo
Gianotti-Crosti syndrome
You are correct. PCR tests of rapid viral swabs from freshly burst vesicles tested positive for enterovirus, confirming the dx of eczema coxsackium, an atypical presentation of hand, foot, and mouth dz caused by coxsackie virus in pts w/ eczema. In contrast to eczema herpeticum (Kaposi varicelliform eruption), eczema coxsackium shows a predilection for eczematous skin, as well as classic hand, foot, and mouth sites.

BMJ 2020;368:l6780