Widespread rash in a 6-year-old boy

Case presentation

A 6-year-old boy presents with a rash that appeared two months ago and spread to involve his whole skin within a week. It is most severe on his trunk (Figure 1) but also involves his face and limbs.

At this presentation, the rash has a polymorphic appearance consisting of papules, vesicles and small scaly macules; there are some areas of pigment loss. At a previous presentation, the rash had been vesicular and thought by the doctor who assessed the patient at this stage to probably be chickenpox.