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Man with leg rash.

Michael Huynh Hwang1, Ziyad Khesbak1, Yiju Teresa Liu1

  • 1Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, USA.

Emergency Medicine Journal : EMJ
|October 1, 2017
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Summary
This summary is machine-generated.

A man presented with a painful, blistering thigh rash and systemic symptoms. This case highlights the importance of considering specific diagnoses for rapidly progressing skin lesions.

Keywords:
musculo-skeletalsoft tissue infectionultrasound

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Area of Science:

  • Dermatology
  • Emergency Medicine
  • Infectious Disease

Background:

  • A 51-year-old male presented with acute onset of a painful, erythematous, and vesicular rash on his bilateral thighs.
  • Associated symptoms included paresthesias, pruritus, fever, vomiting, and diarrhea.

Observation:

  • Physical examination revealed an 8x8 cm violaceous patch with vesicles, erythema, and induration on the left thigh, and a smaller, similarly tender lesion on the right thigh.
  • Bedside ultrasound imaging of the affected areas was performed.

Findings:

  • The clinical presentation and diagnostic imaging were crucial in differentiating between potential causes of the patient's rash.
  • Differential diagnoses included herpes zoster, cellulitis, necrotizing fasciitis, and bullous pemphigoid.

Implications:

  • Prompt and accurate diagnosis of rapidly evolving skin conditions is critical for effective management and patient outcomes.
  • This case underscores the need for a comprehensive approach, integrating clinical findings and diagnostic tools in emergency medicine settings.