Article Text
PDFImage Challenge
Man with leg rash
Abstract
Clinical introduction A 51-year-old male presented to the ED with a rash to his left thigh (figure 1) with erythema, swelling and pain. He endorsed paraesthesias, pruritus, fevers, vomiting and diarrhoea. Initial vitals were unremarkable. He was well appearing with an 8×8 cm violaceous patch on his left medial thigh with vesicles, surrounding erythema and induration with a second, smaller lesion on the right thigh. Both rashes were extremely tender.
Figure 1
Erythematosus and vesicular rash in bilateral legs.
A bedside ultrasound image of the rash was obtained (figure 2).
Figure 2
Bedside ultrasound of rash.
Question What is the most likely cause of the patient’s rash?
A. Herpes zoster
B. Cellulitis
C. Necrotising fasciitis
D. Bullous pemphigoid
- ultrasound
- musculo-skeletal
- soft tissue infection