Review Question - QID 109479

A 34-year-old woman presents to the office complaining of a recurrent rash. She noticed the rash after going in the water at the beach about 6 weeks ago. She reports that since then, she has developed similar appearing pink and itchy rashes on her arms and legs. She states that the rashes eventually resolve on their own. The patient works as a forest ranger at a national park. Her medical history is significant for systemic lupus erythematous and asthma. Her current medications include NSAIDS and an albuterol inhaler. She reports that she has seasonal allergies but no food intolerances. Her temperature is 98°F (36.7°C), pulse is 70/min, blood pressure is 118/77 mmHg, respirations are 13/min, and oxygen saturation is 98% on room air. Upon physical examination, she has diffuse, mild expiratory wheezes. There is no evidence of airway obstruction. When ice is placed on her leg, a rash appears, as pictured in Figure A. Which of the following is the most likely diagnosis?