Table 1

Differential Diagnosis of eczema herpeticum

Eczema herpeticum
  • Sudden appearance of papulovesicular lesions with punched-out, crusted ulcers in chronic dermatitis caused by herpes simplex virus

  • Accompanying symptoms include fever, malaise, and lymphadenopathy2,5

Eczema vaccinatum
  • Recent history of smallpox vaccination or contact with an individual who received vaccination recently

  • Papules, vesicles, umbilicated pustules, or erosions at the site of active dermatitis or previous eczema lesions

  • Lesions might be distant from the inoculation

  • Other symptoms include fever, malaise, and lymphadenopathy

  • Eczema vaccinatum is fatal when it leads to supraepiglottic edema2,5

  • Highly contagious superficial skin infection that mostly affects children aged 2 to 5 y

  • Staphylococcus aureus is the most important causative organism

  • Lesion manifests as a single red papule or macule that quickly becomes a vesicle and an erosion. Subsequently, the content dries, forming honey-coloured crusts

  • Infection commonly resolves spontaneously8

Primary varicella infection
  • Primary varicella infection, also known as chickenpox, is caused by the varicella-zoster virus

  • Initial exanthema consists of disseminated pruritic erythematous macules that progress beyond the papular stage, forming clear, fluid-filled vesicles (like dewdrops on a rose petal)1