A 38-Year-Old Dog Owner With a Blistering, Itchy Rash

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Background

A 38-year-old man presents with a relapsing pruritic rash of 3 years' duration on his buttocks. He has no significant past medical history. Initially, he noticed several small, itchy, red bumps on his upper buttocks that increased in number and size concurrently with the appearance of blisters. The blisters tended to break open after scratching.

The rash first appeared after the patient adopted a dog from a shelter. He suspected that he might have contracted an infection from the dog and self-treated with an over-the-counter topical antimicrobial ointment, with no improvement. He later sought medical attention from his primary care provider, who prescribed a topical corticosteroid cream. Although multiple applications of the topical corticosteroid resulted in improvement, flares would arise when the cream was discontinued.

The patient states that the rash seems to be progressively worsening, mainly during warm weather, but he cannot identify specific triggers. He denies further dissemination of the lesions but recalls having had a similar milder version of the rash on both of his ankles, which subsided after he switched from ankle-cut socks to extra–low-cut socks.

The patient has no other rashes. He denies pain and recent fever or chills, travel, infections, and changes in weight. He is an otherwise healthy radiology technician who lives with his wife and dog. He has not been exposed to a family member or other contact with a similar rash. He changes daily into a clean uniform provided by his workplace and denies the use of new or borrowed clothing. The patient has no known medical allergies and is not taking medication. His immunizations are up to date.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Melba Estrella, Alan Snyder, John Plante, et. al. A 38-Year-Old Dog Owner With a Blistering, Itchy Rash - Medscape - Oct 29, 2020.

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