Acute generalized varicella zoster in the setting of preexisting generalized erythema

We report a 5-year-old girl who initially had generalized erythema from sca rlet fever. Four days later she developed sheets of monomorphous vesicles i n the areas of erythema. A Tzanck smear of a vesicle base showed multinucle ated giant cells, and viral culture grew varicella tester virus, confirming a clinical diagnosis of varicella, This case illustrates that, with a back ground of preexisting erythema, varicella may present in an atypical manner .