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, does not have the rash.
The patient reports that new areas are appearing every morning, despite washing her clothing in hot water. She has tried diphenhydramine, which helped with the itching but made her too sleepy to allow her to take it regularly.
View the image taken (Figure 1) and consider what your diagnosis would be.
Woman with rash