Prepared by John L. Johnson, MD, Department of Medicine, Case Western Reserve University, University Hospitals of Cleveland, Cleveland, Ohio

A healthy 24-year-old male physician traveled to Senegal and the Ivory Coast for 2 weeks to work in a local clinic. During his stay, he visited a beach for swimming and volleyball. Six days later he developed several raised, red, and extremely pruritic lesions on his right foot (Figure).

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