A number of patients presented with an erythematous, purpuric
rash occurring on the legs in association with playing golf and also after prolonged walks or hikes. Many patients believed that it was an
allergic reaction to grasses or
insecticides and had sometimes undergone extensive
allergy testing. We collected reports of 17 such cases from dermatologists in the state of Victoria, Australia. Patients were interviewed by phone and asked to submit photographs of the
rash if possible. Of these, the eruption developed in 15 after playing 18 holes of golf and in three following prolonged hikes. The
rash would usually develop over the summer months under hot conditions. Most patients were over 50 years of age when the tendency to develop the eruption began. Biopsies of the
rash in the active phase showed
leukocytoclastic vasculitis. Patch testing and investigations for potential underlying causes for
vasculitis were negative or unremarkable. It would seem that this is a common but poorly documented condition. The clinical presentation and histology would support the conclusion that it represents a
leukocytoclastic vasculitis induced by prolonged exercise under hot conditions. The findings would suggest that it occurs in healthy people and extensive investigation with blood tests or
allergy testing is inappropriate. We believe the condition should be termed 'golfer's
vasculitis', as golf appears to be the most common precipitating event and such a term would enable the condition to become more widely recognized.