What Is Your Diagnosis? Kaposi Varicelliform Eruption (Eczema Herpeticum)

A 19-year-old man with a history of atopic dermatitis that was managed with mild topical steroids was transferred from a hospital for the management of possible Stevens-Johnson syndrome or toxic epidermal necrolysis. Two weeks prior to admission he reported that he had a high-risk sexual encounter and subsequently developed a rash on his groin as well as dysuria. He was seen by a physician and was treated with intramuscular penicillin for presumed gonorrhea. Several days later the eruption spread to his entire body. He was admitted to an outside hospital with fever and facial lesions that had an oozing purulent discharge. He was treated with vancomycin and levofloxacin and was transferred to our burn unit for debridement. He had crusted purulent vesicles and bullae involving his bilateral arms, face, groin, and penis. Wound scrapings of one vesicle were obtained.