dengue fever rash

Recent travel to the Caribbean is the key clue that led to the diagnosis of Dengue fever, which caused maculopapular rash, fever, headaches, and body aches.

These wounds occurred when this 77-year-old woman fell when chasing her dog. Such wounds — a combination of ecchymoses and erosion caused by blunt and sheering forces on fragile skin— are common in the elderly, even after relatively mild trauma. Simple interventions will promote healing.

These classic linear, wide-mouthed, red to purple, atrophic patches are classic for stretch marks (striae distensae). The patient was in the middle of his growth spurt.

The patient assumed that the itchy rash was due to insect bites. The shape, size, color, and presence of 6 legs of the insect he captured were consistent with bedbugs and bedbug bites.

The red patch on this woman's neck is lichenoid keratosis, a variant of seborrheic keratosis. Diagnostic contenders included Bowen disease and superficial basal cell carcinoma.

Both morphology and location favor the diagnosis of psoriasis. The presence of nail pitting, and a strongly positive family history for psoriasis, confirmed the diagnosis.

These widely scattered, dome-shaped pruritic inflammatory papules suggest insect bites. A biopsy showed mixed dermal infiltrate consisting of lymphocytes and eosinophils, consistent with an arthropod assault.


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