This 68-year-old man was evaluated for a vesicular eruption on his forehead, eyelids, nose and mandible accompanied by erythema and swelling. The Quick Tzanck Test from the vesicles revealed the infiltration of numerous neutrophils, balloon cells and giant cells. Oral valacyclovir for 7 days, topical steroid over the itching areas, and antibiotic ointment for the scratched wounds were prescribed. Two days later the swelling subsided and the vesicles decreased in size. The lesions resolved completely within 10 days. Eighteen months later the patient exeprienced a recurrence. The positive Tzanck preparation helped his clinicians differentiate this eruption from bacterial infection, contact dermatitis, and drug reaction. He was on medications for hypertension and gout.