Acta Dermato-Venereologica 98-4CompleteContent | Page 29

477 An Erythematous Papular Rash on the Left Flank of a 31-year-old Woman: A Quiz Emily RUDD 1 , Nicholas FRANCIS 2 , Luke MOORE 1 and Louise FEARFIELD 1 1 Department of Dermatology, Chelsea and Westminster Hospital, SW109NH London, and 2 Department of Histopathology, Charing Cross Hospi- tal, London, UK. E-mail: [email protected] A 31-year-old woman presented to the dermatology clinic with a two-month history of a pruritic rash on her left flank. The rash erupted as a single erythematous papule and, within days, progressed into multiple papules in a linear distribu- tion. She reported no fever, haematuria or gastrointestinal symptoms. Her past medical history and medication history were unremarkable. On further enquiry she had swum in Lake Malawi two years previously. At that time she did not recollect having a rash or flu-like symptoms. Physical examination revealed firm erythematous papules on the left flank in a linear distribution. A cluster of subcutaneous nodules were palpable adjacent to the rash (Fig. 1). Routine blood tests showed normal full blood count, renal and liver biochemistry and inflammatory markers. A diagnostic skin biopsy was taken (Fig. 2). Fig. 1. Clinical photographs of rash. Fig. 2. Skin biopsy (amplification x120). What is your diagnosis? See next page for answer. QUIZ SECTION This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2018 Acta Dermato-Venereologica. doi: 10.2340/00015555-2870 Acta Derm Venereol 2018; 98: 477–478