question: Viral PCR testing performed on a skin swab did not detect Herpes simplex virus but identified Coxsackie virus, thus confirming a diagnosis of eczema coxsackium. Rapidly worsening eczema, particularly when associated with the development of vesicles, suggests potential bacterial or viral infection. There is mucosal involvement in half of cases and the initial presentation may be indistinguishable from eczema herpeticum.2 Unwell infants should be admitted for antiviral therapy while skin swab PCR results are pending.3 4 The use of wet wrap therapy has been described in the treatment of eczema coxsackium;however, this was not required in this case.5 Complete resolution of the rash was seen following a period of 2 weeks and diligent treatment with emollients and topical corticosteroids.