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Image Description

Skin Manifestations in Coccidioidomycosis: About 20% of patients develop erythema nodosum or erythema multiforme. The presentation consisting of influenza-like symptoms followed by skin lesions (erythema nodosum or erythema multiforme) associated with arthralgia, arthritis, and conjunctivitis has been referred to by a variety of names, including Valley Fever, San Joaquin Valley Fever, desert rheumatism, and desert fever.

This image shows erythema nodosum on the upper back of a patient in response to Coccidioidin skin test. This is delayed-type hypersensitivity reaction resulting from prior exposure to the fungus. Image source: Dr. Lucille K. Georg/CDC; original image is here; use of this image does not constitute its endorsement or recommendation by the U.S. Government, Department of Health and Human Services, or Centers for Disease Control and Prevention.

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