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November 1989

A Rapidly Progressive Papulovesicular Eruption

Author Affiliations

University of Cincinnati (Ohio) College of Medicine

Arch Dermatol. 1989;125(11):1571-1572. doi:10.1001/archderm.1989.01670230113023

REPORT OF A CASE  A 32-year-old woman was referred for evaluation of a rapidly progressive, tender, crusted eruption of the face and upper trunk of 5 days' duration. She had a history of atopic dermatitis and was treated for 3 days prior to referral with prednisone (10 mg/d orally) for possible contact dermatitis. The lesions began periorbitally and spread rapidly over the face and upper trunk despite the systemic steroid treatment.The patient described a similar eruption occurring twice as a child; once at age 8 years after being in a swimming pool near other children who had recently been vaccinated against smallpox, and a second time at age 12 years after she was vaccinated against smallpox. Both outbreaks were limited to the arms.On physical examination, she was afebrile and had a widespread eruption of crusted and umbilicated papules and vesicles on erythematous bases over the entire face, anterior