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40-Year-Old Female with Tender Rash on Hand

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

A 40-year-old female developed a rash on one hand that was tender to touch. She had started on doxycycline the day prior to treat an upper respiratory infection. There is no history of trauma or exposure history.

What is responsible for her tender rash?

Choose one to reveal diagnosis and discussion

Insect bite reaction
Contact dermatitis
Cellulitis
Fixed drug eruption
Underlying arthritis

Answer: Fixed drug eruption

See the full case at Consultant360

This patient had developed a fixed drug eruption to the doxycycline. Changing the antibiotic was sufficient for resolution. Other diagnoses are reasonable, but did not have the history to support them. The erythema was not bright enough for cellulitis and the rash did not center over the joint.