Abstract
A 21-year-old active duty soldier presented with skin lesions distributed on his face, arms, and hands. Two weeks prior to presentation he characterizes the development of lower lip herpetic lesion. He was otherwise well. Three days prior to presentation he was given Valtrex 1000 mg BID. He describes expressing fluid from lesions located bilaterally on his mandibular surface. Later that day, the lesions spread to his arms bilaterally. Throughout the day his hands started progressively swelling. He denies fevers. His past medical history is only significant for oral HSV.
Highlights
A 21-year-old active duty soldier presented with skin lesions distributed on his face, arms, and hands
Urticaria is a generalized pruritic skin reaction due to histamine release, causing areas of edematous plaques surrounded by an area of erythema [4,7]
A prodrome may precede the mucocutaneous lesions by a few days [7]. Those affected are usually children or young adults [4] presenting with widespread atypical target lesions [2] or macular purpuric lesions associated with skin tenderness and burning; erosions and bullous lesions may be evident on the mucosal surfaces [4]
Summary
A 21-year-old active duty soldier presented with skin lesions distributed on his face, arms, and hands. The inferior vermillion was notable for significant crusting, while two small skin colored plaques were present on the superior vermillion (Figure 1). After HSV, the two most common causes of EM are Mycoplasma pneumonia infection and drugs; with non-steroidal anti-inflammatories (NSAIDS) and sulfa medications being the Citation: Tagawa C, DiGiovanni J, Wolf S (2018) Erythema and Acute Pain in the Hands. - Erosions and bullous lesions may be present on mucosal surfaces
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