Arcanobacterium haemolyticum is a bacterial pharyngeal pathogen that infects adolescents and young adults, frequently causing an exanthem that may mimic a viral exanthem, toxic erythema, or drug eruption. To our knowledge, the cutaneous manifestations of A haemolyticum infection have not previously been reported in the dermatologic literature. The severity of this infection can range from mild pharyngitis to a diphtheria-like illness and even septicemia. We report three cases that demonstrate the spectrum of manifestations of this disease, including an unusual case with acral distribution of the associated exanthem. Arcanobacterium haemolyticum infection should be considered in the differential diagnosis when evaluating a young adult with an exanthem. Antibiotic treatment is reliably efficacious, but the throat swab must be specifically cultured on 5% human blood agar in order to make the diagnosis.
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