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June 2013

Targetoid Lesions in the Emergency Department—Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD

JAMA Dermatol. 2013;149(6):751-756. doi:10.1001/jamadermatol.2013.3314e

Findings from a histopathologic examination were remarkable for spongiosis, papillary dermal edema, dermal hemorrhage, and a dense superficial and deep perivascular and interstitial inflammatory cell infiltrate, including numerous eosinophils, lymphocytes, and neutrophils consistent with a hypersensitivity reaction. The patient was treated with topical clobetasol propionate, 0.05%, ointment and oral antihistamines and responded to this treatment within 24 hours. On detailed history, it was revealed that the patient had recently moved into new housing, and given the clinical concern for arthropod bites, an exterminator was sent to her apartment complex, where an extensive bed bug infestation was identified. The patient was seen in clinic 10 days after the initial eruption, and her lesions had resolved.

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