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Medical School Watercooler Newsletter - November 14, 2024, Lindsay Hughes

Watercooler Newsletter

This is the Thursday, November 14, 2024 edition of the Frederick P. Whiddon College of Medicine's newsletter -- Watercolor.

Contents include:

• Medical student presents poster at annual pathology conference
• Upcoming talk to focus on advancing reproductive advocacy in the South 
• Staff recognized for excellence at annual breakfast with the dean
• Cranford to retire from Continuing Medical Education
• Alford joins USA Health OB-GYN and Whiddon COM faculty

Numerical Solutions Of Sird Model Of Covid-19 By Utilizing Pell-Lucascollocation Method, Gamze Yildirim, Şuayi̇p Yüzbaşi

Turkish Journal of Mathematics

This article presents an SIRD model based on the evolution of Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 from the coronavirus family. Firstly, we constitute Pell-Lucas collocation method (PLCM) for this model. According to method, the matrix forms of the Pell-Lucas polynomials (PLPs) are constituted. By utilizing this matrix forms, solution forms and all terms in this model are expressed in matrix form. Thus, PLCM transforms our model into a system of the matrix equations. By solving this system, the approximate solutions are obtained. In addition, the error analysis is also presented. In the examples of this study, we analyzed …

Underutilization Of Influenza Antiviral Treatment Among Children And Adolescents At Higher Risk For Influenza-Associated Complications - United States, 2023-2024., Aaron M. Frutos, Haris M. Ahmad, Dawud Ujamaa, Alissa C. O'Halloran, Janet A. Englund, Eileen J. Klein, Danielle M. Zerr, Melanie Crossland, Holly Staten, Julie A. Boom, Leila C. Sahni, Natasha B. Halasa, Laura S. Stewart, Olla Hamdan, Tess Stopczynski, William Schaffner, H Keipp Talbot, Marian G. Michaels, John V. Williams, Melissa Sutton, M Andraya Hendrick, Mary A. Staat, Elizabeth P. Schlaudecker, Brenda L. Tesini, Christina B. Felsen, Geoffrey A. Weinberg, Peter G. Szilagyi, Bridget J. Anderson, Jemma V. Rowlands, Murtada Khalifa, Marc Martinez, Rangaraj Selvarangan, Jennifer E. Schuster, Ruth Lynfield, Melissa Mcmahon, Sue Kim, Val Tellez Nunez, Patricia A. Ryan, Maya L. Monroe, Yun F. Wang, Kyle P. Openo, James Meek, Kimberly Yousey-Hindes, Nisha B. Alden, Isaac Armistead, Suchitra Rao, Shua J. Chai, Pam Daily Kirley, Ariana P. Toepfer, Fatimah S. Dawood, Heidi L. Moline, Timothy M. Uyeki, Sascha Ellington, Shikha Garg, Catherine H. Bozio, Samantha M. Olson

Manuscripts, Articles, Book Chapters and Other Papers

Annually, tens of thousands of U.S. children and adolescents are hospitalized with seasonal influenza virus infection. Both influenza vaccination and early initiation of antiviral treatment can reduce complications of influenza. Using data from two U.S. influenza surveillance networks for children and adolescents agedattended, laboratory-confirmed influenza for whom antiviral treatment is recommended, the percentage who received treatment was calculated. Trends in antiviral treatment of children and adolescents hospitalized with influenza from the 2017-18 to the 2023-2024 influenza seasons were also examined. Since 2017-18, when 70%-86% of hospitalized children and adolescents with influenza received antiviral treatment, the proportion receiving treatment notably declined. …

Antibiogram Pattern Of Enterococcus Species Among Urinary Tract-Infected Patients Visiting Tertiary Care Hospital In Karnataka, India, Sujatha Bhat, Dushan Uvindu Gunawardana, Delisha Kaur Boparai, Tharinya Kasundie Bamunusinghe

Open Access archive

Background: During the past several decades, enterococci are emerging as an important cause of healthcare-associated infections. They have developed resistance to various antimicrobials previously used for the treatment of urinary tract infections (UTIs). This study was aimed to determine the prevalence of Enterococcus species among urinary tract-infected patients in a tertiary care hospital, in Karnataka, India. Material and Methods: We have analyzed 4341 culture-positive urine samples received by microbiology laboratory during the year 2021. The bacterial identification was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry. The antibiotic sensitivity was tested by automated VITEK-2® COMPACT (bioMérieux) system. Results: …

Systematic Review Of Immune Checkpoint Inhibitor-Related Gastrointestinal, Hepatobiliary, And Pancreatic Adverse Events, Malek Shatila, Hao Chi Zhang, Anusha Shirwaikar Thomas, Antonio Pizuorno Machado, Sidra Naz, Nitish Mittal, Christine Catinis, Krishnavathana Varatharajalu, Carolina Colli Cruz, Eric Lu, Deanna Wu, Julie R Brahmer, Franck Carbonnel, Stephen B Hanauer, Bret Lashner, Bryan Schneider, John A Thompson, Michel Obeid, David P Farris, Yinghong Wang

Faculty, Staff and Student Publications

Gastrointestinal immune-related adverse events (GI irAEs) are common manifestations of immune checkpoint inhibitor (ICI) toxicity. We present a comprehensive systematic review of the incidence, management, and clinical course of irAEs across the entire GI system, including the luminal GI tract, liver, and pancreas. MEDLINE, Embase, Web of Science Core Collection, and Cochrane Library were used to conduct this review. All studies pertaining to GI irAEs were included. Both abstracts and full manuscripts were eligible if they included human subjects and were written in the English language. Articles not available in English, animal studies, or research not specific to GI toxicity …

Internet Of Medical Things: Integrating Machine Learning And Wearables For Healthcare, Jingwen Zhang

McKelvey School of Engineering Graduate Student Theses & Dissertations

The Internet of Medical Things (IoMT), which integrates Internet of Things technologies into healthcare, has become a powerful tool for enhancing health monitoring and predicting clinical outcomes. By leveraging wearable devices, IoMT facilitates continuous, cost-effective, and convenient tracking of patients' health conditions over time. This dissertation applies data-driven methods to address critical clinical challenges involving wearable devices. Specifically, it focuses on three significant clinical problems: (1) indoor contact tracing for healthcare workers using Bluetooth Low Energy (BLE) beacons, (2) predicting surgical outcomes using wearable data, and (3) developing robust models for surgical outcome prediction that account for patient variability using …

Internet Of Medical Things: Integrating Machine Learning And Wearables For Healthcare, Jingwen Zhang

McKelvey School of Engineering Graduate Student Theses & Dissertations

The Internet of Medical Things (IoMT), which integrates Internet of Things technologies into healthcare, has become a powerful tool for enhancing health monitoring and predicting clinical outcomes. By leveraging wearable devices, IoMT facilitates continuous, cost-effective, and convenient tracking of patients' health conditions over time. This dissertation applies data-driven methods to address critical clinical challenges involving wearable devices. Specifically, it focuses on three significant clinical problems: (1) indoor contact tracing for healthcare workers using Bluetooth Low Energy (BLE) beacons, (2) predicting surgical outcomes using wearable data, and (3) developing robust models for surgical outcome prediction that account for patient variability using …

Potential Urban Hazard Zones Of Shanghai, Prc, C. Nicholas Raphael, Jinan Li

The Geographical Bulletin

Land-use data derived from large scale aerial images were used to determine potential hazard zones of Shanghai, People's Republic of China. Using a GIS, nine cultural and physical parameters in onekilometer2 pixels are identified, classified and mapped. A coefficient of urban hazard is calculated per square kilometer within the city. Of the 10 administrative municipalities, Jinan and Luwang, in the central city, are determined as having high urban disaster potential. Natural hazards such as storm surges and subsidence in the delta complex have been recognized and addressed. However, in view of increasing urbanization, urban hazard is yet to be adequately …

An Epidemiological Approach To The Rise In Syphilis In The United States Between 2018 And 2022, Ashley Forrest, Erica Rankin, Lahana Maharjan, Cyril Blavo, Jyotsna Chawla

HCA-NSU MD Research Day

Objective. This study aimed to investigate the recent increase in syphilis rates from 2018 to 2022, utilizing publicly available data from the Centers for Disease Control and Prevention (CDC). Background. Syphilis has seen a dramatic resurgence since 2018, reaching levels not observed since the 1940s. While this increase has prompted significant discourse among healthcare professionals, a comprehensive demographic analysis remains limited. Methods. CDC public datasets from 2018 to 2022 were analyzed descriptively, followed by chi-squared tests and logistic regression modeling conducted using R. The analysis examined syphilis rates across different demographic and behavioral factors, including sex, race/ethnicity, and reported sexual …

Otitis Media Causes In Children And The Role Of Osteopathic Manipulative Techniques In Its Treatment, Laure Deliscar, Jyotsna Chawla, Cyril Blavo

HCA-NSU MD Research Day

Objective: This study was conducted to examine the disease process of pathogens in the middle ear space while considering the effectiveness of treatment methods. Background: Otitis Media (OM) is a common infection of the middle ear, presenting in acute, chronic, and effusion forms. It is characterized by erythematous inflammation of the middle ear space spanning from the tympanic membrane to the end of the eustachian tube, and is often accompanied by fever, earache, and often temporary hearing loss. While OM can affect all age groups, it disproportionately impacts children under the age of 6 and is a leading cause of …

Improving Treatment Outcomes For Bacterial Vaginosis By Affecting The Vaginal Microbiome, Aleya Devries, Jyotsna Chawla Assistant Professor, Microbiology, Jackeline Moljo Assistant Professor, Family Medicine

HCA-NSU MD Research Day

Objective: The goal of this review is to educate providers about the importance of maintaining the balance of the vaginal microbiome (VMB) and how modifiable factors may be used to improve treatment outcomes of patients with bacterial vaginosis. Background: Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age and is treated with Metronidazole, which has a high recurrent infection rate. Preliminary studies highlighted the balance of VMB species affects the development of BV and therapeutic outcomes of Metronidazole. Furthermore, previous studies have described how VMB composition can be shaped by various factors. Methods: Here, we …

Urinary Bladder Neurofibroma Management And Complications, Isabella Cook, Haroon Nawaz

HCA-NSU MD Research Day

Introduction: Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder causing multisystemic manifestations at birth or an early age, with its most prominent symptom being widespread neurofibromas. These neurofibromas can present in any organ, leading to complications depending on their size and location.

Case Presentation: We present a 55-year-old African American female with bilateral nephrostomy tubes after resection of neurofibromas of the bladder.

Deviation From the Expected: The patient developed sepsis due to a urinary tract infection caused by the tubes. Urology and interventional radiology consultants discussed whether to replace the nephrostomy tubes during this admission or wait for her …

Efficacy And Safety Profile Of The Maternal Rsv Vaccine, Abrysvo, Dhanvi Patel

HCA-NSU MD Research Day

Efficacy and safety profile of the maternal RSV vaccine, Abrysvo Dhanvi Patel1, Jyotsna Chawla2, Cyril Blavo3 Department of Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA Department of Foundational Sciences, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA Department of Public Health, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA Abstract: Objective: To study the vaccine efficacy and safety of the FDA-approved maternal respiratory syncytial virus (RSV) vaccine, Abrysvo, manufactured by Pfizer. Background: RSV-associated lower respiratory infections are the leading cause of hospitalizations in …

Case Study: Navigating The Complexities Of Variegate Porphyria, Derek Weimer, Tanya Ramadoss, Una Milovanovic, Sydney Risman, Amber Fouts, Syed Hakeem Shah Md

HCA-NSU MD Research Day

Introduction. Variegate Porphyria (VP) is a rare autosomal dominant disorder characterized by mutations in the protoporphyrinogen oxidase (PPOX) gene, leading to dysfunctional heme biosynthesis. The clinical manifestations of VP are highly variable, including significant neurovisceral symptoms and cutaneous photosensitivity. This variability reflects the disease's ability to often go undiagnosed, especially in pediatric populations where the disease is not frequently seen in clinical practice. Case Presentation. This case study focuses on a 12-year-old male who presented with persistent photosensitivity, painful blistering, severe abdominal pain, and dark-colored urine. Despite normal renal and liver serology testing, elevated porphyrin levels in both urine and …

Flexor Tenosynovitis Of The Wrist And Hand Due To Non-Tuberculous Mycobacteria, Mariafe Reyes, Tatevik Malisetyan, Skylar Harmon, Mohammadali M. Shoja Md, Gary B. Schwartz Md

HCA-NSU MD Research Day

Title: Flexor Tenosynovitis of the Wrist and Hand Due to Non-tuberculous Mycobacteria Authors: Mariafe Reyes1,Tatevik Malisetyan1, Skylar Harmon1, Mohammadali M. Shoja, MD1 Gary B. Schwartz, MD1 1Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA INTRODUCTION: Non-tuberculous mycobacteria (NTM) are a group of bacteria, including Mycobacterium marinum, Mycobacterium kansasii, and Mycobacterium avium intracellulare (MAI), that usually exist in the soil and water sources. The most common site of infection is the lungs, but extra-pulmonary involvement of the skin and rarely the musculoskeletal (MSK) system does occur, especially the hands and wrists. CASE PRESENTATION: A 45-year-old, …

Comparison Of Bacterial Meningitis Complicated By Stroke In Adults Versus Children: A Scoping Review, Isabella Cook, Apurva Ramanujam, Afrida Sara, Arjun Nair, Sabina Chon, Erick Boldt, Miranda Londono, Alan Wang, Sarah Mohamed, Shivani Dave, Yuri Zagvazdin

HCA-NSU MD Research Day

Title: Comparison of Bacterial Meningitis Complicated by Stroke in Adults versus Children: A Scoping Review Authors: Isabella Cook, OMS-II; Apurva Ramanujam, OMS-II; Afrida Sara, OMS-II; Arjun Nair, OMS-II; Sabina Chon, OMS-II, M.S.; Erick Boldt, OMS-II; Miranda Londono, OMS-II; Alan Wang, OMS-II, M.A.; Sarah Mohamed, OMS-II; Shivani Dave, OMS-II; Yuri Zagvazdin, Ph.D. Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, Florida Background: Bacterial meningitis (BM) complicated by stroke in adults include distinct manifestations compared to children. Although there are notable differences in presentations between children and adults, there is limited availability in research defining a protocol for …

The Lived Experiences Of Nurses Caring For Dying Pediatric Patients, Danna L. Curcio

Dissertations

The purpose of this research study was to explore the lived experiences of nurses caring for dying pediatric patients. Nurses and health care professionals may at times have difficulty adjusting and processing when life ends and this may have the potential to interfere with patient care. Reflection on past events and actions enable critical discovery of strategies to benefit both nurses and patients. The method for conducting this research study was from a qualitative phenomenological perspective exploring the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of …

Genital Hair Removal And Sexually Transmitted Infections: A History And A Systematic Review Of The Literature, Alison O. Marshall

Dissertations

Background: Genital hair removal is a popular practice in Westernized cultures and has been associated with the belief that removal is necessary for hygiene. A body of literature exists that has found that genital hair removal is associated with adverse health outcomes, including sexually transmitted infections (STIs). This dissertation aims to detail the history of the practice, why the hygiene belief exists, and to systematically review the existing literature that assesses genital hair removal and STIs.

Methods: Historical, socio-cultural analysis from the feminist perspective was performed on the literature to outline why genital hair removal was adopted at a population …

The Impact Of Disaster Tabletop Exercise On The Nursing Knowledge Of Emergency Preparedness And The Influence On Professional Quality Of Life, Vivian Fuentes

Dissertations

It is widely reported that nurses are underprepared to respond to a disaster event, despite the available resources for emergency preparedness education. The purpose of this project was to measure the impact of disaster tabletop exercises on emergency preparedness knowledge of the emergency department (ED) nurses and its influence on the professional quality of life. Twentynine nurses from a south Florida hospital participated in the evaluation of this evidence-based project. The Professional Quality of Life (ProQOL) and adapted Emergency Preparedness Information Questionnaire (EPIQ) were implemented before and after disaster tabletop exercises. The EPIQ findings included an overall 20% increase in …

Emergency Preparedness Curriculum: Essential Skills For Nurses Responding In Disasters, Sallie J. Shipman

Dissertations

The purpose of this study is to examine the lived experiences of nurses first time responding to a civilian disaster response in shelters or temporary community medical clinics in an attempt to identify the essential knowledge and skills necessary to provide care to disaster victims. The theoretical framework for this study was the theory of novice to expert, experiential learning, clinical reasoning, and using real life situations to develop the student's sense of salience by Benner et al. (1996, 2009; 2010).

Sepsis Escape Room: A Game-Based Learning Approach For Nurses, Emily Selby Dnp, Aprn, Accns-Ag, Ccrn, Lauren Knepper Msn, Rn, Chse

Nursing Research & Professional Development Conference

Background

After recognizing inefficiencies with system-wide online sepsis education, a Sepsis Coordinator developed an education plan utilizing multiple modalities to engage learners. One resulting activity was a Sepsis Escape Room. Escape rooms can enhance teamwork, confidence, and motivation while increasing knowledge and retention in an active learning environment.

Purpose

The purpose of the Sepsis Escape Room activity was to provide a unique, game-based learning opportunity for nurses to reinforce knowledge of sepsis, while demonstrating problem-solving skills in a team to solidify real-life processes.

Methods/Evaluation

The Sepsis Escape Room was redesigned from another site and implemented in collaboration with the simulation …

Meet Me In The Midline: Decreasing Risks Of Clabsi In Rehabilitation, Brandy Marler Bsn, Rn, Crrn, Heather Cox Bsn, Rn, Crrn

Nursing Research & Professional Development Conference

Introduction and Context 

The problem identified is a recent increase in Central Line Associated Blood Stream Infections (CLABSI). The rationale for addressing this problem is to decrease the number of infections through the use of a nurse-led decision tree and the development of a midline IV access program. The goal is to improve patient care by reducing the incidence of CLABSI infections and to empower nurses by giving them more autonomy and decision-making power in patient care. These initiatives allow nurses to take a more active role in preventing CLABSI infections and improving patient outcomes.

Implementation Strategy 

A nurse-led education …

Nurse-Driven Sepsis Bpa Usability Improvement, Emily Selby Dnp, Aprn, Accns-Ag, Ccrn, Susan Dziura Msn, Rn, Tns, Cpps, Melinda Jamil Ms

Nursing Research & Professional Development Conference

Introduction & Context

A site noted a safety trend related to the Sepsis Best Practice Advisory (BPA). Cause analysis determined that BPA usability contributed to delays in ordering sepsis labs per nurse-driven protocol and led to a serious safety event. The goal was to enhance BPA usability and increase compliance with the protocol.

Implementation Strategy

Nurses partnered on BPA redesign to improve wording, clarify when to order labs, and simplify ordering. To evaluate the new design, the Human Factors Engineer and stakeholders conducted a usability test. Usability testing gathers observations and feedback from end-users to identify opportunities before investing resources …

Enhancing Patient Safety: A Virtual Approach To Reducing Urinary Catheter Utilization In Critical Care, Karen Marshall Mha, Rn, Ne-Bc, Anna Starnes Rn, Bsn, Michelle Reed Dnp, Msn, Nea-Bc

Nursing Research & Professional Development Conference

Introduction and Context

From mid-2020, the Critical Care Unit at Atrium Health Lincoln consistently exceeded a urinary catheter utilization ratio of 1.0. This ratio was higher than other critical care units within the system and failed to meet established targets. Elevated urinary catheter utilization rates are associated with catheter-associated urinary tract infections. In the first quarter of 2023, the infection rate of the Critical Care Unit was 3.76 per 1,000 catheter days, posing a safety risk to patients.

Implementation Strategy

Before intervention, the process of discontinuing urinary catheters relied on nurses requesting removal from physicians. Despite having a nurse-driven protocol …

Quality Of Newborn Care And Associated Factors: An Analysis Of The 2022 Kenya Demographic And Health Survey, John Baptist Asiimwe, Earnest Amwiine, Angella Namulema, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Shamim Nabidda, Imelda Namagembe, Lilian Nuwabaine

School of Nursing & Midwifery, East Africa

Kenya one of the African countries has pledged to reduce neonatal death as per the 2030 World Health Organization target. Providing high-quality newborn care is critical in minimizing neonatal mortality. This study aimed to determine the factors that influence the quality of newborn care in Kenya. Secondary data from 11,863 participants of the 2022 Kenya Demographic and Health Survey (KDHS) were analyzed. The participants were chosen using two-stage stratified sampling. The quality of newborn care was operationalized as receiving all components of newborn care after childbirth, as reported by the mother. Using SPSS (version 29), univariate and multivariable logistic regression …

The Predictive Relationship Between The Percentage Of High School Students Experiencing Homelessness And On-Time Graduation, Michelle Lee Wiggs

Doctoral Dissertations and Projects

The purpose of this predictive correlational study was to determine how accurately the percentage of students in Oklahoma high schools who graduate on-time be predicted by the percentage of those students who experienced homelessness during their four years of high school. The theoretical framework for this study came from Maslow’s Hierarchy of Needs, resiliency theory, and grit theory. A bivariate linear regression analysis was conducted to examine predictive relationships between the criterion variable, percentage of students who graduated from high school on-time of Oklahoma high school students, and the predictor variable, percentage of youth experiencing homelessness (YEH). Archival data from …

The Impact Of The Coronavirus Disease 2019 Pandemic On Urban Nonprofit Organizations In A Southeastern City, Yvette Michelle Brown

Doctoral Dissertations and Projects

This qualitative study examined the impact of the coronavirus disease 2019 pandemic on human services nonprofit organizations in an urban setting and the strategic measures implemented by the leaders to remain focused on their mission. The logic of inference was that the pandemic significantly impacted these nonprofit organizations, forcing the public administration leaders to implement new innovative strategies that should be documented. The study data was collected and analyzed through three streams of data: interviews with nonprofit or public administration leaders, surveys of nonprofit employees, and document analysis of organizational financial reports over four years. The results from the interviews …

The Efficacy Of Suboxone As Mat Therapy For Women: A Phenomenological Study, Sara C. Swepston

Doctoral Dissertations and Projects

The Opioid Epidemic has plagued the nation for decades, with little success in treating patients for long-term sobriety. Billions of dollars are spent annually treating patients with opiate use disorder, most popularly with the pharmaceutical drug, Suboxone. However, evidence and research are lacking to truly understand if the synthetic opiate medication works in treating women with OUD. The purpose of this phenomenological study is to know from the women who have been treated using Suboxone if the medication works. The participants are all women, aged 18-45 who used Suboxone for Medically Assisted Treatment for a minimum of 90 days. The …

Covid-19 And Pregnancy: A Comprehensive Study Of Comorbidities And Outcomes, Shang-Ming Zhou, Hossein Ahmadi, Lin Huo, Lisa Lix, Kate Maslin, Jos Latour, Jill Shawe

School of Nursing and Midwifery

ObjectivesThis study aimed to investigate the impact of pregnancy and pre-existing comorbidities on COVID-19 infections and associated complications of hospitalisation and mortality in women of reproductive age (WRA). The study also compared the risk of severe COVID-19 complications between pregnant women (PW) and non-pregnant women (NPW) with and without pre-existing comorbidities. Special focus was placed on some understudied comorbidities of immunosuppression, chronic renal disease and chronic obstructive pulmonary disease (COPD).MethodsThe study utilized anonymized patient-related information for a population of 7,342,869 WRA from the Mexican Ministry of Health data repository on COVID-19. Descriptive variables were characterized using frequencies, percentages, means, and …

Atypical Rash As A Presentation Of Pityriasis Rosea In A 23-Month-Old., Kedar Tilak, Erica Ray, Majo Joseph

Manuscripts, Articles, Book Chapters and Other Papers

Pityriasis rosea is a self-limiting skin disorder that can occur in pediatric patients. We report an atypical presentation of a 23-month-old male with a generalized rash similar in appearance to pityriasis rosea. We then review the literature on pityriasis rosea and its application to pediatrics. Our patient had the rash as the only presentation which was also atypical in appearance as opposed to the regular rashes seen with pityriasis rosea which makes this case further interesting. We only treated the case symptomatically and the patient had spontaneous resolution of symptoms.