ORCID

0000-0001-6210-9667 (Lo), 0009-0009-4322-3697 (Schaffer)

Document Type

Article

Publication Date

2026

DOI

10.1016/j.acepjo.2025.100290

Publication Title

JACEP Open

Volume

7

Issue

1

Pages

100290

Abstract

[Patient presentation]

A 41-year-old male with no past medical history presented with 1 week of ulcers to the left side of his face, followed by several days of a painful rash to the trunk and back after a sexual encounter. The patient denies any fever or previous rash and any illicit drug use. Initial vital signs included a temperature of 97 °F, a heart rate of 89 beats per minute, and blood pressure of 135/79 mm Hg. Physical examination revealed a macular papular rash across his trunk and back (Fig 1) and facial ulcerations with eschar (Fig 2) at the same stage. Laboratory findings showed a white blood cell count of 6.9 K/μL. Testing for human immunodeficiency virus (HIV) syphilis, herpes simplex virus, gonorrhea, and chlamydia was negative. Polymerase chain reaction (PCR) for monkeypox tested positive.

Rights

© 2025 The Authors.

This is an open access article under the Creative Commons Attribution 4.0 International (CC BY 4.0) License.

Original Publication Citation

Lo, B. M., Shoemaker, M., Potter, K., & Schaffer, K. (2026). A painful diffuse rash. JACEP Open, 7(1), Article 100290. https://doi.org/10.1016/j.acepjo.2025.100290

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