Photo Quiz

Pruritic Rash on the Forearm and Legs

 


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Am Fam Physician. 2016 Jul 1;94(1):51-52.

A 37-year-old man presented with a three-day history of itching and erythema on his right forearm and legs. There were bumps, blisters, and swelling in the area of the redness. He first noticed the rash on his forearm after walking back to his car from an overnight fishing trip. The next day, he noticed the rash on his legs. He was otherwise feeling well.

Physical examination revealed multiple papules and vesicles with erythema and edema (Figure 1). The erythema covered most of his legs, and some of the vesicles were oozing. There were no other physical findings. He was afebrile.


Figure 1.

Question

Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?

A. Cellulitis.

B. Herpes simplex virus infection.

C. Poison ivy dermatitis.

D. Urticaria.

Address correspondence to Natasha M. Rowe, MD, at natasha.rowe.1@us.af.mil. Reprints are not available from the author.

Author disclosure: No relevant financial affiliations.

REFERENCES

1. Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, Scotland: Mosby; 2010.

2. Habif TP, ed. Skin Disease: Diagnosis and Treatment. 3rd ed. Edinburgh, Scotland: Saunders/Elsevier; 2011.

3. Bingham CO. New-onset urticaria. UpToDate. May 14, 2015. http://www.uptodate.com/contents/new-onset-urticaria (subscription required). Accessed December 7, 2015.

This series is coordinated by John E. Delzell Jr., MD, MSPH, Assistant Medical Editor.

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