Red Tender Nodule on a Pregnant Patient.

Previously published Photo Quizzes are now featured in a mobile app. Get more information at http:// www.aafp.org/afp/apps. A 22-year-old pregnant woman (gravida 2, para 1) presented with a sore throat and tonsillar exudates at eight weeks’ gestation. Group A rapid streptococcus antigen test results were positive, and streptococcal pharyngitis was diagnosed. She was treated with amoxicillin. On the seventh day of antibiotic treatment, she returned to the clinic with a tender skin nodule on her left anterior leg, and a different antibiotic was prescribed. On physical examination, the patient had a low-grade fever and multiple erythematous nodules on both of her shins (Figures 1 and 2). The nodules were tender but had no ulceration or drainage. After no response to two weeks of oral antibiotic therapy, she was admitted to the hospital and intravenous antibiotics were initiated. A wound culture had no bacterial growth, and a complete blood count was within normal limits.