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JAMA Clinical Challenge
October 8, 2014

Intensely Pruritic Eruption in a College Student

Author Affiliations
  • 1Albert Einstein College of Medicine, Bronx, New York
  • 2Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
JAMA. 2014;312(14):1458-1459. doi:10.1001/jama.2014.7086

A 21-year-old college student presents for evaluation of an intensely pruritic eruption on the ankle and sole of his right foot. The patient recently returned from a trip to Puerto Rico. He noticed the lesions approximately 1 week after his return. He has no significant past medical history. On physical examination, the patient is in overall good health. Notable findings include 3 red, serpiginous lesions on the heel (Figure, A), lateral area of the midfoot (Figure, B), and ankle, some with vesicles. Vesicles were also noted over the Achilles tendon.

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