Facial rash : a case study

A male university student, 24 years of age, presented to his general practitioner because of a facial rash. He had a past history of eczema but no other significant past medical history and no allergies. He was not taking any regular medications. One week earlier, he had experienced a low grade fever and a sore throat associated with a flare-up of his eczema. At that time, he had seen another GP who prescribed mometasone furoate 0.1% (1 mg/g) ointment, one application daily, and oral cephalexin 500 mg, two tablets twice daily. The patient was compliant with this treatment but now reported that since the initial consultation, the rash had worsened (Figure 1). The patient was afebrile and normotensive with a regular heart rate of 62 bpm. He had cervical lymphadenopathy, which was more significant in the right anterior triangle of the neck. The rash was confined to his face. Eye examination was unremarkable. A skin swab sent for viral polymerase chain reaction showed herpes simplex virus type 1, and microscopy culture and sensitivity results were unremarkable.