Journal of Urgent Care Medicine

25-Year-Old With Hand Rash

A 25-year-old man undergoing chemotherapy with cyclophosphamide, vincristine, doxorubicin, and dexamethasone for acute lymphoblastic leukemia arrives in urgent care because he’s developed a painful, burning palmar eruption. On examination, tender, shiny, erythematous papules and plaques were seen on the palms and fingers as well as the soles of his feet. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

Consider Patient Environment And Critter Infestations That May Cause Pruritus

Scabies, bedbugs, and body lice commonly cause pruritus and rash, and accurate diagnosis of the symptoms should include consideration for social drivers of health, such as housing status and living environment, according to a recent literature review presented in JAMA. It’s concerning because pruritus may persist after scabies treatment—largely due to misdiagnosis and inadequate treatment—and persistent scratching can present a risk for skin infection. While bedbug bites usually resolve after 1 week without treatment, professional …

Abstracts in Urgent Care – September 2024

Can Large Language Models Help in Assessing Acuity of Patients Presenting to ED? Take Home Point: Integration of large language models (LLMs) in the emergency department (ED) could enhance triage processes. This warrants further investigation particularly in the urgent care (UC) space. Citation: Williams C, Zack T, Miao B, et. al. Use of a Large Language Model to Assess Clinical Acuity of Adults in the Emergency Department. JAMA Netw Open. 2024 May 1;7(5): e248895. doi: …

21-Year-Old With Heel Lesion

A 21-year-old man presents to urgent care concerned about a painless blackish lesion that had developed on his left heel. On examination, a stippled, deeply violaceous, blackish patch with overlying scale was seen on his plantar heel. He had no history of dermatological disease but mentioned he played in a basketball tournament last week. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on …

FDA Warns of Skin Infections After Med Spa Treatments

A recent Food and Drug Administration (FDA) warning cautioned consumers and medical professionals about adverse events associated with injection lipolysis—a series of injections meant to break down fat cells in the areas around the injection sites. They are often delivered in spa-type settings as cosmetic procedures. The agency said the applications are sold online under the names Aqualyx, Lipodissolve, Lipo Lab, and Kabelline and are not FDA-approved treatments. Side effects include permanent scars, serious infections, …

51-Year-Old With Asymptomatic Rash

A 51-year-old man presents to urgent care concerned about an asymptomatic rash that developed over his face within the last month. On examination, pink and violaceous, annular, scaly papules, and plaques were seen on his cheeks and within his beard area and nasolabial folds. The patient appeared well and reported no systemic symptoms. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

Unexplained Rash in a 3-Year-Old Girl

A mother brings her 3-year-old daughter to your urgent care center, concerned about a rash that developed at the same time the girl started having a runny nose and low-grade fever, and became slightly lethargic. Now her cheeks are bright red, and she has a blanching macular rash that’s spread slowly from her extremities to her trunk. View the image and consider your next steps, along with possible diagnoses.

Hyperpigmented Skin Patches

A 70-year-old man presents to an urgent care center after becoming concerned about brown hyperpigmented patches on his legs and arms. He says that he thinks some of his teeth are turning gray, but it has been happening so slowly that he is not sure. He reports that he has been in good health recently, especially after starting to take antibiotics last year to treat his rheumatoid arthritis. View the image taken (Figure 1) and …

Skin Rash with Pustules on a Newborn

A healthy, full-term baby girl was born to a healthy mother who had adequate prenatal care and no signs of infectious diseases. Three days after birth, the baby developed multiple 1-mm pale-yellow to yellow pustules within a large inflammatory wheal on her cheek. Several hours later, the rash starts to resolve. View the image taken (Figure 1) and consider what your diagnosis would be.

Woman with rash

This image was taken of a 44-year-old female who presented to the urgent care center with an itchy rash on her arms and legs that she has never had before. Four 4 days ago, she returned from a church retreat at a camp where she slept in a cabin in the woods. Most of the retreat was indoors. She is the only one with a rash and her husband, who slept in a different bed, …

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