Man with leg rash

Emerg Med J. 2017 Oct;34(10):686-691. doi: 10.1136/emermed-2016-206523.

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.emermed;34/10/686/F1F1F1Figure 1Erythematosus and vesicular rash in bilateral legs.A bedside ultrasound image of the rash was obtained (figure 2).emermed;34/10/686/F2F2F2Figure 2Bedside ultrasound of rash.

Question: What is the most likely cause of the patient's rash?A. Herpes zosterB. CellulitisC. Necrotising fasciitisD. Bullous pemphigoid.

Keywords: musculo-skeletal; soft tissue infection; ultrasound.

Publication types

  • Case Reports

MeSH terms

  • Exanthema / etiology*
  • Fasciitis, Necrotizing / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Thigh / abnormalities*
  • Tomography, X-Ray Computed / methods
  • Ultrasonography / methods