Presenter: John P. Minni, DO and Dwayne D. Montie, DO

Dermatology Program: Columbia Hospital

Program Director: Layne D. Nisenbaum, DO

Submitted on: January 1, 2008

CHIEF COMPLAINT:  “My son gets a rash when he goes outside”

CLINICAL HISTORY: 7 yo male with several month histories of a pruritic red rash which occurs minutes to hours after sun exposure. Patient has tried topical low potency steroids without success. The patient’s mother later related that the patient suffers from frequent cold sores.

PHYSICAL EXAM:
Multiple annular and later targetoid plaques on face and trunk especially in sun-exposed areas.

LABORATORY TESTS:

HSV IgG +

DERMATOHISTOPATHOLOGY:

Cell poor interface dermatitis with occasional dyskeratotic cells and viral cytopathic changes. EBV in-situ hybridization was negative.

DIFFERENTIAL DIAGNOSIS:

1.   Juvenile Spring Eruption
2.   HSV Induced Erythema Multiforme
3.   Drug-induced Erythema Mulitforme