Prepared by Kevin Griffiths, MD, MPH, Resident, and Rajendra Kapila, MD, Associate Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark
A 25-year-old Japanese man returning to Japan from a vacation in Jamaica was transferred from a local airport (during a stopover in the United States) for evaluation of a suspicious neck lesion that was noticed by a fellow passenger. His medical history revealed no constitutional symptoms or animal contacts, but he reported that he had had 2 sexual encounters while in Jamaica. Physical examination revealed multiple circular vegetative, erythematous pustules with thick yellow crusts on the chest, abdomen, axilla, lower extremities, and upper back (Figure).
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