ABSTRACT
A 67-year-old man presented to hospital with a rash covering his legs. He said the rash had developed over the course of several days and was spreading from his feet up toward his trunk. The rash was not pruritic or tender to touch. He denied any fevers, cough or shortness of breath. He had not been exposed to any chemicals or changed his usual toiletry products or detergents. For 1 week preceding the rash, the patient had been experiencing pain around the small joints of his hands and swelling of both knees bilaterally. His past medical history included a 2-year history of intermittent episodes of abdominal discomfort that had been investigated extensively at his local hospital and diagnosed as irritable bowel syndrome. He took mebeverine for his occasional abdominal pain but no other medications. He was a retired social worker who neither drank alcohol nor smoked tobacco. He had travelled to Egypt 18 months earlier but had not been abroad since.
