Symmetrical vesicular eruption on the palms.

Volume 85, Number 8 www.aafp.org/afp American Family Physician 811 A 30-year-old woman presented with a nonpruritic vesicular eruption on the palms that began one week earlier. One day before the rash developed, the patient had a burning, tingling sensation in the same area. She did not have a fever or other systemic symptoms. The review of systems was unremarkable, and she was not pregnant. The patient had zoster on her trunk 10 years earlier, but no known recent contact with anyone who had a similar rash. Physical examination revealed multiple vesicles on the palms in various stages of healing with faint surrounding erythema (see accompanying figure). There was no fluctuance, induration, warmth, scaling, or exudate.