A Unilateral Facial Rash with Eye Involvement

A 67-year-old man with a history of chronic obstructive pulmonary disease came to the Emergency Department with a 2-week history of a left-sided facial rash. Two days after the rash appeared as small erythematous papules on his forehead, he was seen at an outside hospital and treated with oral cephalexin and doxycycline for presumed cellulitis. He presented to our Emergency Department due to progressive expansion of the rash despite compliance with antibiotics. His rash now extended over the left scalp and forehead, involving the upper eyelid, but did not cross the midline of the face.