A 51-year-old Filipino man presented with a 4-day history of painful red bumps on his face, neck, and right wrist. He also complained of a mild headache. He denied fever and chills. His medical history included rheumatic heart disease, thrombocytopenia, allergic rhinitis, and a benign cyst on his forehead. His surgical history was significant for repair of a bilateral inguinal hernia and excision of a benign left axillary cyst. He had started taking loratadine–pseudoephedrine sulfate (Claritin-D) tablets 5 days before the cutaneous findings appeared. His only other medication was a multivitamin.
Canacci AM, Thornton SL, Sood A, Bergfeld W. Painful Plaques and Nodules on the Face, Neck, and Right Wrist of a 51-Year-Old Man—Quiz Case. Arch Dermatol. 2005;141(3):389-394. doi:10.1001/archderm.141.3.389-d