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Painful rash in a screaming toddler
  1. Sarah Sweeney Pinney1,
  2. Julia Kauffman1,
  3. Sharon R Hymes2
  1. 1 Dermatology, KP Dermatology, Houston, Texas, USA
  2. 2 Dermatology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Sarah Sweeney Pinney, KP Dermatology, Houston, TX 77024, USA; Sarahpinney{at}

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Clinical introduction

A healthy 2-year-old boy developed a sudden-onset painful rash while on a walk outdoors in Texas. The caretaker noted that the walk was uneventful, and the course taken was a paved neighbourhood sidewalk travelled many times without incident. During the walk, the toddler picked up rocks, leaves and various other objects on the ground. On exam, edematous plaques with lymphangitis were noted on the left arm. He was inconsolably …

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