Case presentation A 23-month-old male was brought to the emergency department with a one-week history of rash. According to his mother, this was the first time he had developed such a rash. It began on the upper back as red (Cover Image A), raised lesions and later spread to the face and abdomen.

The rash was non-pruritic. Medical history No associated symptoms No recent fever, rhinorrhea, cough, vomiting, diarrhea, irritability, or lethargy No known food or drug allergies No prior hospitalizations No history of routine medication use No known exposure to potential allergens such as plants, soaps, or detergents Other children in the household had no similar rashes or skin findings Initial examination Well-appearing, playful, and interactive; no acute distress Vital signs within normal limits Eyes clear, no exudates Moist mucous membranes; no oral lesions or rhinorrhea Equal chest rise;โ€ฆ