A 45-year-old female presents with a complaint of an itchy red rash on her arms and legs for about two weeks.

She has been going on a daily basis to the local YMCA with children for Summer camp.

(T) 98.3°F; (RR) 18; (HR) 70, regular; (BP) 118/74

healthy-appearing female in no acute distress

EYES: no injection, no increase in lacrimation or purulent drainage;  EARS: normal  TM: Normal

mild edema with inflammation located on forearms, upper arms, and chest wall, thighs and knees; primary lesions are a macular papular rash with secondary linear excoriations on forearms and legs