We report on a 4-year-old boy suffering from typical infantile papular acrodermatitis with an unusual course. The eruption occurred seven weeks before the signs and symptoms of hepatitis. Only trace concentrations of hepatitis B surface antigen (HBsAg) could be detected after three weeks history of the disease. The lesions which persisted for nine weeks were itching, and there were signs of superinfection. We found only localized lymphadenopathy. The condition developed into a chronic HBsAg carrier state.