Prepared by Kevin Griffiths, MD, MPH, Resident, and Rajendra Kapila, MD, Associate Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey?New Jersey Medical School, Newark

A 25-year-old Japanese man returning to Japan from a vacation in Jamaica was transferred from a local airport (during a stopover in the United States) for evaluation of a suspicious neck lesion that was noticed by a fellow passenger. His medical history revealed no constitutional symptoms or animal contacts, but he reported that he had had 2 sexual encounters while in Jamaica. Physical examination revealed multiple circular vegetative, erythematous pustules with thick yellow crusts on the chest, abdomen, axilla, lower extremities, and upper back (Figure).

What?s Your Diagnosis?

Allergic contact dermatitis

Pediculosis

Nonbullous impetigo

Herpes simplex virus infection