A diffuse and morphologically diverse rash in a traveler

Presenter: Leslie Marshall, D.O.
Dermatology Program: Northeast Regional Medical Center
Program Director: David Cleaver, D.O.
Submitted on: Jan 5, 2017

CHIEF COMPLAINT: 22-year-old Hispanic female presented complaining of an “itchy rash.”

CLINICAL HISTORY:

Signs and symptoms: A previously healthy, non-pregnant 22-year-old Hispanic female presented with a 5-day history of a pruritic eruption on her dorsal right hand, upper arms, and back. She had returned to the United States 4 days prior after a 2-week trip to Santa Anna, El Salvador. Her symptoms began one week after her arrival to El Salvador with neck swelling and general malaise. One day before returning home (day 7 of illness), she developed tenderness and swelling surrounding a mosquito bite on her right ankle followed by a rash on her arms, back, and thighs. Accompanying symptoms included arthralgias in her hands, a low-grade fever, headache, and paresthesias.

 

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