patient started horseback riding full-time some months ago. | Figure 1

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Patient Case Summary

Patient started horseback riding full-time some months ago. Around the same time these lesions/rash appeared on both outer thighs. They come and go a little bit and only symptom is #Pruritus. Patient is otherwise in good health, no prior diseases and uses no medication. She came back a week after the first picture was taken as the rash/lesions had gotten worse with a more intense itch (see next pic). Any thoughts on what this might represent? Suggested treatment?

Additional Cases

20-year-old male presents with this single maculopapular lesion that appeared about 4-5 weeks ago as a red raised bump that was/is non-pruritic and not painful but felt “a little rough.” This is the first time he has sought treatment because he noticed 2 days ago the surrounding petechiae and the petechiae within the lesion. There is no associated pain, pruritis, fever, or illness. No new exposures, sick contact, known insect bites. No significant PMH. Allergy? Experienced a rash after PCN as a child. No medication, vapes, infrequent ETOH. He has not tried any OTC treatment/topicals. Thoughts?

Healthy 30yo male on no meds presents with rash for 4 days. No other symptoms at all and VSS. He noticed the rash 4 days prior while in a rural area for holiday weekend. No reported tick bite. The rash does not blanch and involves both legs entirely and slight involvement of the suprapubic area. They itch slightly. Some lesions actually have a vesicle-like appearance with serous drainage. Nothing purulent.

25-year-old man presented with a 6-month non-healing ulcerative lesion not painful or pruritic. Patient refers lesion began as a mild bite and it turned into an ulcer. Lab: scraped lesion inspection, promastigotes.

21 m/o M with Mom c/o rash to b/l lower extremities x 1d. Blistering lesions to R ankle and the other lesions appear to be unroofed blisters. UTD immunizations. Rash spares the soles, palms, mouth. No obvious pain, pruritus, new topical products, recent illness, fever, travel/time outdoors. They don’t appear consistent with insect bites. Bullous impetigo? Thoughts? Thanks.

Trending Cases

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?