An 8-day-old boy was eval...

An 8-day-old boy was evaluated for a sudden-onset pustular rash that had developed while he was being monitored for neonatal abstinence syndrome in the neonatal intensive care unit. He had been born at term through spontaneous vaginal delivery. There was no maternal history of genital herpes. Physical examination revealed multiple scattered erythematous papules and pustules measuring up to 5 mm in diameter on the scalp, face, neck, and upper chest (Figure 1A). There were no comedones, and the palms or soles were not involved. A complete blood count and C-reactive protein level were normal. Bacterial culture and Tzanck smear of the pustule contents were negative. A potassium hydroxide preparation of a pustule scraping was performed for further analysis (Figure 1B).