Case:  16 yo wrestler, 5 days ofpainful rash to forehead, associated with malaise and headache.  Treated with Keflex at OSH without improvement...

Q:  Diagnosis and Treatment?

A:  Herpes Gladiatorium, Valacyclovir

Cutaneous infection with Herpes Simplex Virus type 1 (HSV-1), highly infectious, skin to skin contact spread, also known as “scrum pox” (for rugby) and “mat pox.”  Most commonly seen on head, also found on extremities and trunk.  Vesicular rash, sometimes painful, often accompanied by lymphadenopathy, fever, sore throat and headache.  Look for eye involvement!  Consider bacterial superinfection.  Can recur.