These lesions on the distal thigh of a middle-aged woman featured erythema with irregular faded borders and central redness (top) with very fine papules (bottom) over the L3 dermatome. Microscopically, lesions of herpes simplex, herpes zoster, and varicella are nearly identical. The degree of leukocytoclasia and hemorrhage seen in the specimen in this case strongly suggested herpes zoster and, to a lesser degree, varicella.

