25 yr old male seen for non-pruritic rash that developed int | Figure 1

25 yr old male seen for non-pruritic rash that developed into the lesions seen above. Patient stated that it appeared a few hours after fly fishing in waders and walking through the woods. Localized to the calves. Thoughts?

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Case Summaries

• Progressive macular hypomelanosis:

  Progressive macular hypomelanosis was my initial dx. Pt was seen in ER, so I don't have f/u. Just wondering other derm input in favor or against! Thanks!

• 11 year-old female lesions:

  An 11-year-old, female who came to clinic with these lesions which were noted for several months now. It was not itchy. What are they?

• 33 year old Hispanic male:

  33 year old Hispanic male. A construction worker. Comes to ER and admitted for " pain all over my body for the last 3 weeks." It hurts on his hips and his knees and his shoulders and his legs. He also mentioned that it hurt so much that he ended up with SOB and chest pain too... Working diagnosis: chest pain rule out ACS and SOB...

• 42 year-old male spots:

  42 yo healthy male seen in clinic. Asked about "spots" that have been present for last 6 months. They are present on the abdomen and back. Slightly pruritic, no drainage, appear to be increasing in quantity. Benign PMHX.

• 52-year-old man with chest pain:

  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.

• 28-year-old woman intense pruritus:

  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.

• 4-month-old male infant:

  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.

• Teen presenting after collapse:

  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?