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A patient presents with a rash in the belt region after walking in the woods. What is the likely cause?

Poison ivy exposure

Chigger mite larvae

The presence of a rash in the belt region after walking in the woods is suggestive of exposure to chigger mite larvae. Chiggers, which are the larval stage of certain mites found in grassy or wooded areas, can attach to the skin and cause localized pruritic rashes. The rash typically appears as small, red, itchy welts and commonly occurs in areas where clothing fits tightly, such as around the belt line.

The timing of the rash relative to the recent outdoor activity strongly points to chigger exposure, as this type of rash often develops within hours to days after contact with infested vegetation. Other conditions, like poison ivy exposure, would usually present with a different appearance and develop in a more variable pattern depending on the amount of exposure. Tick bite allergies can result in a rash, but they are less common and would often be associated with other systemic symptoms. Fungal infections, while they can cause rashes, are typically associated with different risk factors and exposure scenarios.

Overall, the context of walking in the woods and the characteristics of the rash align most closely with chigger mite larvae as the likely cause.

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Tick bite allergy

Fungal infection

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