A 71-year-old man with a history of bronchiectasis presents with a painful rash and swelling of his right foot for 1 day. He has had no fevers, joint pain, recent trauma, or new exposures to the area. He was diagnosed with bronchiectasis of unknown etiology 6 years ago and notes a worsening of his cough and dyspnea over the past few months. A recent computed tomography scan of the chest revealed mild bronchiectasis and ground glass inflammation (Figure, left), and recent pulmonary function tests showed combined obstructive and restrictive defects. His medications include albuterol inhaler, fluticasone-salmeterol inhaler, guaifenesin, and loratadine.
Renati S, Raff A, Burgin S. Painful Rash in a Patient With Bronchiectasis. JAMA. 2015;313(13):1366-1367. doi:10.1001/jama.2015.0985