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BACKGROUND
A 34-year-old, otherwise healthy man presents to the
emergency department with a chief complaint of a
pruritic rash on the left lower part of his chest. The
patient describes having swelling and pain at the same
site 5 days earlier, but these symptoms have since
disappeared. He denies having rashes elsewhere, exposure
to new medications or foods, having insect or tick
bites, or using new soaps or lotions. The patient
recently returned from a vacation to a tropical region,
where he was snorkeling. However, he cannot immediately
recall any unusual exposures or injuries. He denies
having fevers, wheezing, difficulty breathing, nausea,
or upper respiratory symptoms.
The patient has normal vital signs, and the physical
findings are remarkable for only 2 distinct linear,
erythematous, and vesiculopapular rashes on the left
lower aspect of the chest wall (see Image).
What is the diagnosis? |
Hint
The patient recalls brushing up against
something while snorkeling during his vacation. |
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Authors:
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Alison Richard, MD, Attending
Physician, Department of Emergency Medicine, LAC/USC Medical Center, Los
Angeles, Calif
Matthew Richard, MD, Attending Physician, Department of Emergency
Medicine, Antelope Valley Medical Center, Los Angeles, Calif |
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eMedicine
Editors:
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Erik Schraga, MD, UCLA - Olive
View Medical Center Residency, Department of Emergency Medicine, Olive
View - UCLA Medical Center
Rick G. Kulkarni, MD, Assistant Professor, Yale School of Medicine,
Section of Emergency Medicine, Department of Surgery, Attending
Physician, Medical Director, Department of Emergency Services, Yale-New
Haven Hospital |
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