Author:  Edidiong William Udofa / Editor: Thomas MacMahon /  Codes: DC1, SLO1, SLO5 / Published: 23/01/2020

A 7-year-old boy is brought to your ED by his dad with a mild cough and an intensely pruritic blanching papular rash on the dorsum and palmar surfaces of both hands, especially between his fingers, groin, over both elbows and sparsely on both his legs. His vital signs are within normal limits and the remainder of his examination is unremarkable. Symptoms are worse at night. His 4-year-old brother attended with similar complaints the day before. He was prescribed some chlorphenamine for symptomatic relief and asked to follow up with his GP. However, the symptoms have persisted according to Dad.