Wednesday, July 14, 2010

What is the Diagnosis?

This 24 year old patient had the onset of these very itchy lesions on both upper arms.  She takes no medication and has no other medical problems.  She had just returned from a vacation where they had lots of outdoor dining.  She recalls eating shellfish and strawberries.  You are the doctor.  Make a comment and tell us what is the diagnosis?  Can it be treated?

The answer will be posted tomorrow.

(Case and Image from ConsultantLive)

14 comments:

stop smoking help said...

Nodular prurigo or insect bites.

gradydoctor said...

A delayed (Type IV) hypersensitivity reaction from some kind of irritant contact dermatitis or some delayed hypersensitivity to shellfish or strawberries. If they weren't itchy, one could consider erythema nodusum. . . .the insect bite one is good, too. Hard to ignore the fact that she'd eaten strawberries and shellfish, but would expect an immediate reaction to those.

M.scott said...

Looks like a combination of strawberry allergy with some bug bites mixed in

sunnydalai said...

Some bites; no allergies.

CountryMidwife said...

Having seen this on my own body a thousand times too many I have to go with insect bites, too. And she's probably fair complected and has an "over active" immune system (ie seasonal allergies, exaggerated response to immunizations with fever, etc). Maybe even pregnant?

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