History: The patient is a 50 year old white female with a four day history of pruritic rash which started on her lower back and spread to arms as well. In spite of the pruritic nature of the rash, she denies scratching and reports that she cannot even reach the portion of her back where the rash occurs. She does endorse eating a mushroom based sauce approximately 48 hours prior to the onset of the rash. She has not tried any treatment. She has never had a similar rash, and she has not spent any length of time outdoors.
Past medical history: premature ventricular contractions, asthma, hypothyroidism, GERD
Social history: Denies alcohol and smoking
Family history: Father- hypertension and abdominal aortic aneurysm, Grandparents- colon cancer
Medications: Ortho tri cyclen, levothyroxine, Prilosec, flovent
General: alert, oriented and in no acute distress
Face: No abnormalities noted
Neck: No abnormalities noted
Chest: No abnormalities noted
Back: erythematous and edematous linear/flagellate plaques
Abdomen: erythematous and edematous linear/flagellate plaques
Upper extremities: few erythematous and edematous linear/flagellate plaques
Lower extremities: No abnormalities noted
Digits/nails: within normal limits
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