Travelers returning from the tropics often present with rash/fever. Those with rash/fever and myalgias/arthralgias are most likely due to chikungunya fever, dengue fever, or Zika virus. In these arthropod viral transmitted infections, the rash may be pruritic. The case presented here is that of chikungunya fever remarkable for the intensity and duration of her pruritis.

A 65-year-old woman presented with the sudden onset of feeling ‘‘hot,’’ accompanied by a diffuse, blanching red rash, conjunctival injection, and one episode of nonbloody diarrhea. It happened suddenly about 90 min after consuming a dinner that included fully cooked tuna. It was also associated with mild diffuse pruritus, and the patient reported feeling restless. The patient reported that her ...

Cholestasis is defined as decrease in bile flow due to impaired secretion by hepatocytes or obstruction of bile flow through intrahepatic or extrahepatic bile ducts. Intrahepatic cholestasis of pregnancy is a condition characterized by pruritis in the second half of pregnancy. It persists until delivery after which it caeses promptly. A genetic background is suggested by family clustering and d...

Data from the 2002 outbreak in the United States suggested that rash appears in approximately one-half the patients with WN fever [2], which may be more frequent than with neuroinvasive disease [3]. The rash is typically maculopapular, involves the chest, back and arms, and generally lasts for less than one week (show picture 1). The rash is sometimes accompanied by complaints of dysesthesia an...

A 24 year old lady presented with pruritis and lichenified nodular skin lesions for 1 year. She also had clinical features to suggest a superior venacaval syndrome (SVC) with large rubbery cervical lymph nodes. She was subsequently diagnosed to have Hodgkin lymphoma on lymph node biopsy. Skin changes in lymphoma can precede other clinical symptoms by months. High clinical suspicion and thorough...