A 1-month-old baby girl presented with a two-week history of a vesicular eruption followed a week later by warty papules in a whorled array on her body. There was no family history of similar disease. The baby was afebrile and did not seem to be in distress. Wright’s stain of the vesicle contents demonstrated many eosinophils. Tissue biopsy showed epidermal edema (spongiosis) and eosinophils. Dental, eye, and ear examinations were normal.
The patient was a 39-year-old Hispanic woman who presented with a vesicular eruption along her T4 dermatome. She had no relevant past medical history and took no medications. The patient reported a low-grade fever (100°F) as well as pre-eruption tingling and pain in the area from her breast to her back. A chest x-ray and manual blood smear did not reveal any pathology. A Tzanck smear taken from the base of the vesicles revealed many multinucleated giant cells.