What Is This Rash on an Infant’s Feet?
Christa Root, DO, MPH
Resident Physician, Department of Pediatrics, University of South Florida, Tampa, Florida
Sharon Dabrow, MD
Professor of Pediatrics, Department of Pediatrics, University of South Florida, Tampa, Florida
A 5-month-old African American girl presented to a general pediatric clinic for an emergency department (ED) follow-up visit with a rash on her feet, soles, hands, and palms.
The infant had an unremarkable medical history—she had been born at full term and had been healthy prior to the onset of the rash. She did not attend daycare, and no one else in the household had been sick or had had a rash.
The mother reported that the girl had seen multiple providers for the rash, which had not improved. The infant reportedly had been treated with several courses of permethrin for possible scabies, with no improvement in the rash. She then had been seen in the ED and had received a diagnosis of a viral infection.
At a clinic follow-up visit 1 week later, the patient received a diagnosis of varicella. The rash was pruritic and was minimally relieved with diphenhydramine.
She returned to the clinic 2 weeks later for lack of resolution of symptoms. Upon examination at that time, crops of vesicles were present on her soles (Figure) along with a few sporadic vesicles across her abdomen and back.