He was not able to visualize or identify what caused this skin irritation. He remained asymptomatic until eight hours later when the involved area of skin began to itch as well as hurt. Worsening pain prompted this ED visit. He has no other complaints. He is healthy and takes no medications.
Immunizations are current.
He denies tobacco, alcohol and illicit drug use. The patient is an alert male in mild discomfort. Vital signs are normal. The lesion is 2 by 2 centimeters with 2 areas of ecchymosis with circumferential pallor.