Abstract Introduction: Influenza vaccination (flu vaccine) is associated with some musculoskeletal and neurological complications despite its wide use and significant safety profile. Skin is one of the most common systems for drug reactions and side effects. Skin rashes such as bullous eruptions and vasculitis have been reported, but viral exanthem are seldom reported in association with the influenza vaccine. In particular, herpes simplex virus-2 reactivation and myelitis following influenza vaccination manifesting as severe herpes simplex virus type 2 and associated with blisters on the back of a single patient have been reported before. However, data on the rate of such complications are scarce in the literature. Patient concerns: A young woman complained of an unusual presentation of eruptive vesicular skin lesions following influenza vaccination complicated by allergic contact dermatitis to lemon soap applied to the lesions. Diagnosis: Viral exanthem were diagnosed based on clinical presentation and supported by a skin biopsy. Interventions: Medical treatment with antiviral and corticosteroids. Outcomes: The patient had a favorable outcome. Conclusion: Dermatologists should be vigilant to the association with any new medications and skin lesions, observe the progression of the lesions, and revisit the medical history to establish the correct relationships for any possible new causative agent to an evolving or new developing lesion.