Herpes Zoster and Molluscum Contagiosum

For a few days, this 73-year-old woman had had an itchy, painful rash on the right side of her face (A). Despite its proximity to her eye, she had no ocular involvement and no blurring of vision.

This red, almost vesicular eruption could be confused with acne rosacea or the rash of systemic lupus erythematosus; however, these conditions usually affect both cheeks.

This was the rash of herpes zoster. The patient’s herpesvirus titer was elevated; she responded well to acyclovir (B). Also of interest in this case are the 3 lesions on this patient’s forehead (C).

These are classic umbilicated papules of molluscum contagiosum, which are not to be confused with herpetic vesicles.