14654 Young William

Coining (in Kentucky, USA?)

Young male living in Kentucky, USA with no travel history presents with a rash and a fever. Vital signs normal except low grade fever. Blanching macular rash with "target lesions" and no oral or mucosal involvement. Prominent red streaking confused the picture until "coining" therapy was inquired. Image reveals the EM rash overlaid by the coining abrasions.