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Sometimes, the sudden onset of a rash calls for a skin biopsy. Here, a 37-year-old
African American man presented to the emergency department with the complaint of an
itchy, generalized rash (Figure 1A,1B) that had come on suddenly the previous day. He also reported that sore throat,
fever, and chills had begun 2 days prior to presentation, and he denied cough, headache,
nausea, vomiting, or diarrhea. Although the patient was morbidly obese, he was otherwise
healthy. He reported occasional use of ibuprofen for routine aches and pains over
the past several years.
Figure 1(A) Diffuse, small (1-3 mm) pustular rash covered the patient’s abdominal wall. (B)
A similar rash covered all 4 extremities as well. The right forearm is shown.
Detection of Group A beta-hemolytic Streptococcus employing three different detection methods: culture, rapid antigen detecting test, and molecular assay.