55 year old female pesented with a 6-week history of a rash, which started on the forearm and gradually spread to involve the entire arms bilaterally and also the thighs, as well as most recently the upper chest. The lesions are minimally itchy at onset, but
basically are fairly asymptomatic. The lesions are also persistent and not transient.
The rash apeared a few days after a visit to the woods. However, the patient does not recall a tick bite.