ABSTRACT
This chapter provides a detailed description of a 24-year-old fashion design student who presents to the accident and emergency department with a 1-week history of feeling unwell with a temperature, abdominal pain, diarrhoea and headaches. Overnight he has developed a widespread asymptomatic rash, mainly over his face and trunk. His college friend was worried about him and brought him to the hospital. The patient reports being previously well although he admitted to having a penile discharge a few weeks previously that had settled spontaneously. He has not travelled outside the UK for at least 5 years. He takes no prescription medication but takes occasional vitamin supplements. Multiple small erythematous macules and papules were seen over the patient’s face, neck and trunk, with scattered lesions on his limbs. Conjunctivae were unaffected; he had a slightly ‘coated’ tongue but no ulceration in his mouth. Genital examination was normal. He had shotty lymphadenopathy in the cervical region.
