Differential diagnosis of skin complaints following an ocean holiday:
(1) swimmer’s itch (cercarial dermatitis) due to Schistosoma cercariae
(2) seabathers eruption due to jellyfish larvae
(3) ghost anemone dermatitis
(4) cutaneous larva migrans or folliculitis due to hookworm
(5) fish stings or venoms
(6) insect bites (Tunga penetrans, etc)
(7) dermatophyte infection
(8) sun or thermal burn
(9) contact dermatitis
(10) photosensitivity
(11) plant toxin
(12) plant thorn or abrasion
(13) bacterial infection
(14) sexually-transmitted disease
(15) other medical conditions (dermatitis herpetiformis, cholestasis, etc)
(16) drug reaction
Initial questions:
(1) travel itinerary
(2) onset relative to trip
(3) other people affected
(4) medications
(5) risky behaviors
The next step is to determine the distribution of skin lesions:
(1) bathing trunk distribution
(2) feet
(3) hands
(4) legs
(5) sun-exposed skin
(6) torso
(7) generalized
