Плямиста гарячка Скелястих Гір
Rocky Mountain spotted fever initially manifests as a blanching macular rash on the palms, wrists, soles, and ankles, then progresses proximally to the neck, face, buttocks, and trunk. The lesions darken and become maculopapular and then petechial.
Image courtesy of the Public Health Image Library of the Centers for Disease Control and Prevention.