Disney rash mimicking cellulitis in two healthy young adults: A case report

Background Cellulitis is a common, potentially serious bacterial skin infection, warranting oral or intravenous antibiotics based on severity and immunity of the patient. Exercise induced vasculitis is commonly overlooked and results from prolonged standing and walking. It mimics cellulitis and management warrant rest, compression bandages and symptomatic treatment. Differentiating exercise induced vasculitis from cellulitis helps to curtail the use of unnecessary antibiotics. We present two young adults who developed exercise induced vasculitis and features that helped in differentiating it from cellulitis. Case presentation Two otherwise healthy young adults presented with painful erythematous lesions in lower limbs associated with pain, swelling, chills and sweats. They had been standing for long hours. Although cellulitis was considered as the most likely initial diagnosis, detection of lesions in both lower limbs, normal laboratory parameters, evidence of similar illness among few other healthy adults made exercise induced vasculitis more likely. Both responded well to keeping limbs elevated, compression bandages and pain relief. Conclusion Exercise induced vasculitis should be considered in patients who develop painful tender lesions in lower limbs mimicking cellulitis especially have engaged in activities involving prolonged standing, because this illness can be managed with simple measures and does not warrant antibiotics.