Case Challenge: A Spreading Summertime Rash

Neil Gaffin, MD


July 13, 2018

A Macular Rash in a Healthy Man

A healthy 42-year-old man presents to the emergency department with a 3-day history of headaches, arthralgias, and a rash. He works in finance and plays golf frequently. He has not been hiking or camping recently, and he has had no recent travel, sick contacts, or insect bites.

An exam reveals a well-appearing patient with scattered large macules (Figure 1). The remainder of the exam is normal. The findings of routine lab work, including a complete blood count with differential and a complete metabolic panel, are unremarkable.

Figure 1. Rash on the patient's back (left) and abdomen (right). Courtesy of Neil Gaffin, MD.


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