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History

A 23 year old gardener presents with a 6 week history of an intensely itchy rash on his arms, throat and upper back. The pruritus is 'driving him mad' and has not improved despite treatment with antihistamines and strong topical steroids. He works in a plant nursery and handles many plants, particularly grevillea. He also has a 3 year history of occasional episodes of genital herpes (for which he has no treatment) but is otherwise in excellent health and has no known allergies.He has 2 cats but doesn't think that they have any more fleas than usual.