A 43-year old veterinarian presented to my office with this | Figure 1
A 43-Year-Old Veterinarian Case
A 43-year old veterinarian presented to my office with this rash. Everything started 4 days ago, when he was with his colleague, to some village to examine cows on the big farm. The cows were healthy as was stated by patient. After he returned home, he noticed few of these red spots on his body which was slightly pruritic. During next days, the more red spots appeared, and 2 days ago he started to notice this erythematous streaks between them. He still has no other symptoms, and the pruritus is less intense.
On exam, the red spots are actually red raised patches/plaques with surrounding blanching erythema that continue to the red streaks. The right side of the body is more affected than left.
As a veterinarian, he works only with cows. His colleague has the same rash, which started on the same day as his. The patient recalls only mosquito bites that day.
My thought is that this is not infection. I think about insect bites with aggravated skin reaction.