September 2014





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

Allergies: Tetracycline


Physical exam

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

Mood: pleasant

Digits/nails: within normal limits


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