DISCUSSION
The patient had golfer's vasculitis, a benign condition seen primarily in middle-aged persons after they have played a round of golf in hot weather. The condition is also seen in walkers and joggers.
Ruling out other diagnoses in contrast to this patient's eruption, contact dermatitis is rarely exclusively macular and often includes a local vesicular reaction. Pointed questioning uncovered no history of medication use, including OTC medications. No history of fever or other constitutional symptoms associated with leukocytoclastic vasculitis were reported. Because petechiae and purpura in general are symptomatic of leukocytoclastic vasculitis, Wegener's granulomatosis, rheumatoid arthritis, lupus, and other autoimmune disorders, golfer's vasculitis occasionally prompts a vigorous evaluation by a dermatologist or rheumatologist and results in needless expense and angst. The urinary findings ruled out an acute hemolytic process and renal dysfunction.
A self-limited disorder, golfer's vasculitis typically disappears spontaneously in 24 to 48 hours but frequently recurs with additional hot-weather activity. There is no known cure or preventive method other than avoidance of vigorous activity in hot weather. Application of cool compresses to the lower legs may reduce swelling and the mild pruritus that is sometimes associated with the condition. JAAPA
Arnold Metz is an assistant professor in the PA program at the Medical University of South Carolina in Charleston. The author has indicated no relationships to disclose relating to the content of this article.
Acknowledgement: The author wishes to acknowledge the contribution of Daniel E. Lewis, MD, in the preparation of this article.
Joe R. Monroe, PA-C, MPAS, department editor