Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
A 35-year-old man came into our clinic with a rash that had developed a week earlier after a trip to a North Carolina beach. The rash started on his upper inner arms (not including his axilla) and then developed in his groin, thighs, buttocks, and the tops of his feet. There was no rash on his back, head, or neck. The rash was a maculopapular eruption with some confluence, and it had a discrete distribution in his bathing suit area.
The patient said the rash was very itchy, although it had improved over the past couple of days. He did not have any systemic symptoms and hadn’t used any new soaps or detergents, nor had he recently worn any new clothes. He did note, however, that he’d experienced a similar rash in the past after trips to the beach, although the previous rashes were not as severe.
None of the other family members who’d accompanied him to the beach had developed the rash.
FIGURE
A discrete maculopapular eruption in the bathing suit area
WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?