You are correct. Tzanck smear and PCR confirmed a herpes simplex virus (HSV) type 1 infection. Eczema herpeticum, also known as Kaposi varicelliform eruption, is a potentially life-threatening herpetic disseminated infection mostly caused by HSV type 1 or 2. It resembles varicella, its main differential dx. Blisters are monomorphic and typically appear all at once on skin previously affected by atopic dermatitis or other skin diseases that break down the skin barrier. Typically, blisters become hemorrhagic, crusted, and eroded in 24-48h. Secondary bacterial infection w/ staph or strep may lead to impetigo and cellulitis. This pt was treated w/ both IV acyclovir and amoxicillin/clavulanate for 1wk and made a full recovery.

Emerg Med J 2017;34:314.