H.P.I. The patient is a 70 yo woman who has had ~ 10 episodes of a cellulitis-like picture of her legs over the past ten years. She has never had fever or constitutional signs. The process can affect one or both lower extremities. I saw her in 2001 for this and then she was referred by the emergency room yesterday with the same picture. It began with a fall two days ago. She hit her hip -- was in pain and took ibuprofen before this episode. She said she does not recall taking this before other episodes.
O/E: Patchy, fiery erythema of left lower extremity. Very mild erythems of right lower leg (mostly around the ankle).
Clinical Photos:
Labs: Biopsy obtained and CBC ordered
Diagnosis: Is this an atypical cellulitis, or toxic erythema secondary to and NSAID?
Discussion: If the patient remains afebrile and wbc is normal, I'd be inclined to just watch and wait.
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