Coxsackie eruptions concentrated in areas of atopic dermatitis, a phenomenon termed eczema coxsackium, has been well described in the literature but, to our knowledge, the concentration of coxsackie viral lesions to areas of ichthyosis has not been reported. This case describes a rare presentation of coxsackie viral lesions concentrated in areas of epidermolytic ichthyosis in a 3-year-old boy