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A 35-year-old white woman presented with grouped vesicles and superficial crusting on both lips and grouped erosions on the gingiva and hard palate. The lesions erupted two days earlier with fever (101°F) and flulike symptoms. The patient had severe pain when swallowing and was taking acetaminophen with some relief. She had recently undergone chemotherapy for acute myeloid leukemia. She had visited an urgent-care clinic three days earlier with sore throat and headache, but rapid strep assay was negative. Physical exam revealed cervical lymphadenopathy and pharyngeal erythema but no other lesions.

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