Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• It seems unlikely that Mr. Martin is reacting to a localized radiation exposure. No history to go with this.
• Antigen/antibody reaction with a vasculitis is a possibility, but one expects this to be generalized rather than localized. Still it's a remote possibility.
• A localized skin toxin is a possibility, but these almost always produce some form of epithelial reaction first. What we see here is purely dermal.
• As for the Staph toxin, these tend to produce generalized changes. Besides, somewhere we need a Staph infection to be the source of the toxin (as in toxic shock syndrome).
• It seems that a form of infectious vasculitis is the most likely.