White, middle-aged male patient visited me today for two year checkup. Patient originally visited me in July 2013 for pain in both knees. Patient had a case history of being physically active, including repetitive squats with weights, outdoor running, basketball, sprints, and climbing stairs. I noticed the patient had bowed legs, putting him at higher risk for uneven cartilage wear, and thus knee pain.
Patient complained of onset of red rash on his left leg below the knee in January 2014. Patient described an “unbearable” itch during a 20-minute onset of the condition, and described himself as being kneeled down on carpet at the time. The patient responded with vigorous fingernail itching, leaving red skin contusions. The contusions persisted as petechiae but without any itch.
In July 2014, the patient sought diagnostic testing which revealed he was low in vitamin D and high in cholesterol. The patient had feared autoimmune disease because of rash persistence by this point but testing showed normal leukocyte levels and no autoimmune disease markers.