A 23 y/o female medical student, on vacation in Florida presents with a painful red rash. The rash is located in several different patterns. There is a rectangular pattern on her left thigh, and also 2 linear streaks on her right leg and mildly on her left leg. It initially was just red and painful, but progressed to very painful blisters. Pain was to the extent that she was unable to wear pants, as the pain was unbearable if anything touched her left thigh lesion. She also felt the lesions were possibly spreading as she noted a spot behind her left ear, on her forehead, and on her abdomen a day or two after the rash started. The rash was not pruritic. The rash on the thigh had a red area that was spreading beyond the initially involved rectangular area. No unusual bites or new exposures. No new soap, perfume or clothes.
There were no constitutional symptoms, no fever, vomiting, etc. She had traveled from Detroit, Michigan to West Palm Beach, Florida for winter break, and had spent some time the first few days on the beach doing yoga. She didn’t recall any bites from anything.
PMH, SH, FH were found unremarkable. Physical exam is normal except for skin findings.
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