Case History:

43 yo Hispanic female presented with a rash

Contributed By:
John H. Riggs III, MBA, DC, FACO
Case Presentation: Page 1 of 6

Case History:  43 year old Hispanic female presented on a Saturday morning with a rash, numbness on the left side of her body (not face) and progressive weakness.  She thought she was having a heart attack the prior evening and went to the ER.  She again returned for follow-up the following Monday with worsening ambulation and weakness on the left side.

The patient stated her symptoms started several months earlier when she picked up her grandbaby and her left arm went numb.  She was in considerable initial pain which eventually subsided.  She noted that he had had a rash on her arms, legs, back and abdomen for 7 months.  After the rash developed, her hand cramped into a fist.  See Figure 1 and 2.  She was treated by a massage therapist to straighten the hand out which helped some.  She denied taking any medication.  Her medical doctor noticed her hand, however, decided to pursue her rash first indicating he thought she had a pinched nerve in her neck. He had suggested a MRI which she could not afford.  She was using a prescribed cream for her skin rash but didn't know what it was called.


Figure 1

Figure 2


Question:  What working diagnoses would you consider at this time?

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