Photo Quiz

Rash on the Ankle

 

Am Fam Physician. 2019 Dec 15;100(12):773-774.

A 65-year-old man presented with a rash on his right ankle that developed four days prior. The rash began as a single papule but progressively spread. The patient reported itching but no pain or tenderness. He applied bacitracin and triamcinolone to the rash without improvement. The patient had a history of basal cell carcinoma, actinic keratosis, and seborrheic keratosis. He had recently visited the North Carolina coast immediately after a hurricane impacted the area. On physical examination, he was in no acute distress, and his vital signs were normal. A vesicular rash extended approximately 3 cm × 1 cm anterior and slightly superior to the right medial malleolus in a serpentine pattern. A second, smaller lesion was located directly superior to the same malleolus (Figure 1).

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FIGURE 1


FIGURE 1

Question

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

Address correspondence to John E. Snellings, MD, FAAFP, at snellije@evms.edu. Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.

References

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This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

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