skip to main content

Eczema herpeticum — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardRheumatology and dermatologyEczema herpeticumRACP Paediatrics

A 2-year-old with severe atopic dermatitis develops fever and rapidly worsening painful vesicles. The lesions are monomorphic, punched-out erosions over the face and flexures. He is irritable and has periorbital swelling. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Eczema herpeticum

Painful monomorphic punched-out vesicles in a child with eczema suggest eczema herpeticum, a dermatological emergency. Impetiginised eczema tends to cause honey-coloured crusting rather than uniform erosions and systemic toxicity. Early antiviral therapy and ophthalmology review are important when facial or eye involvement is possible.

Reference: RCH Eczema guideline; Therapeutic Guidelines (eTG)