A HEALTHY, 9-year-old boy from rural Pennsylvania had a 2-month history of tender, well-demarcated, erythematous plaques studded with pustules on his neck, back, and chest (Figure 1). Prior to referral, he had not responded to multiple medications, including topical steroid creams, clotrimazole/betamethasone diproprionate and mometasone furoate, and oral antibiotics, erythromycin ethylsuccinate and cephalexin.