An extensive perioral rash

HSV gingivostomatitis characteristically presents with an eruption of vesicles which have an erythematous halo-like margin and a paler central portion over the perioral region; typically, these coalesce and break down to form shallow ulcers, and with time crust over to create a scab. (fig 2). Diagnosis is confirmed by isolation of HSV, either from immunofluorescence or through HSV DNA polymerase chain reaction, obtained by swabbing denuded skin lesions.3 Intravenous acyclovir for 7-14 days reduces the duration of viral shedding and shortens recovery time.34 Learning points HSV mucocutaneous infection in immunocompromised patients can be extensive and spread rapidly if not managed early. [...]details of BMJ policy on financial interests is here: https://www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists/declaration-competing-interests Provenance and peer review: not commissioned; externally peer reviewed. 1 Kolokotronis A Doumas S. Herpes simplex virus infection, with particular reference to the progression and complications of primary herpetic gingivostomatitis.