I was asked to see an 8-year-old girl with a vesicular rash which on first observation appeared to be smallpox (variola), as all the lesions were at the same stage of development. In fact, the sheet-like distribution was confined to the back, and the abdomen and face had the typical appearance of chickenpox (varicella).

It was discovered that the patient and her brother (unrelated sibling by adoption) had both had a two-day prodrome, then had gone to the beach where they acquired a mild sunburn.

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