A 32-year-old female presents with a headache and a rash on her trunk and extremities. She has had unprotected sex with multiple partners over the last two months, but denies any history of sexually transmitted infections. Examination reveals generalized non-tender lymphadenopathy, a diffuse macular rash on her chest and arms, and patchy hair loss. Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody-absorption (FTA-ABS) tests are both positive, and she is given a single dose of penicillin G benzathine intramuscularly. She returns within a few hours with a worsening rash (seen here), myalgia, and a fever.
A. Commence doxycycline
B. Supportive treatment
C. Intramuscular adrenaline
D. Antihistamines
Find the answer, discuss this case, and more on Figure 1.

Explore cases, quiz yourself, and solve medical mysteries along with thousands of other medical professionals around the world on Figure 1, the free app where doctors expand their clinical knowledge.
Continue Your Research
Next Step for Applicants
Use this article as a handoff into structured school research, forum insight, and the next stage-specific resource.
Research Schools
Move from broad interest to structured program research for Medicine.
ValidateExplore the SDN Forums
Learn from premeds, medical students, and physicians sharing real experience in the SDN Forums.
AdvanceApplication Guide
Stay on track with SDN guidance for deadlines, secondaries, interviews, and decisions.
Need advice?
Use SDN expert support when you want confidential answers now or more longitudinal pre-health advising focused on acceptance.
Ask an Advisor
Ask a quick confidential question in an anonymous setting and hear from SDN verified expert advisors. Always human, always free.
Acceptance StrategyWork with a Pre-Health Coach
Work longitudinally with SDN's pre-health coach on application strategy, planning, and decisions that can strengthen your application.
