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An 8-year-old male is brought to urgent care by his mother reporting a widespread, itchy facial rash. The patient says that the rash is severely painful and pruritic, and that he feels tingling and pain in his lips. The facial rash presented 3 days prior, and the mother states that her son repeatedly scratches the legions. The patient and is family are from Honduras; they deny any recent travel. The patient is otherwise well and denies any systemic symptoms. No treatments were tried for symptoms at home. Physical exam reveals normal vitals, and widespread scaly, eroded, and crusted plaques are visible on the child’s face and upper lip.
View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.