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The popularity of international travel continues to increase among Americans, even though they often experience subsequent illness on return from their journey. The pathogens responsible are not necessarily endemic to the destination itself but are often the result of poor sanitary conditions or activities engaged in while away. Skin disease ranks third among all medical concerns in returning travelers. This review addresses the pathogenesis, epidemiology, clinical presentation, and treatment of the most common skin diseases in returning travelers: insect bites and bedbugs, cutaneous larva migrans, scabies, tungiasis, myiasis, leishmaniasis, viral exanthems, and marine envenomation. Primary care physicians and dermatologists should be familiar with these illnesses and a general approach to their evaluation and management. Key PointsArthropod assault and infestation is a source of significant morbidity in returning travelers.Travelers should bring proper protective clothing and insect repellant when travelling to areas where biting insects are vectors of disease.Travelers should be acquainted with the hazards associated with local marine life if they plan on entering the water.

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Pyoderma gangrenosum (PG) is a rare ulcerative skin disease of unknown etiology often associated with systemic inflammatory conditions, most commonly inflammatory bowel disease (IBD). The most common presentation of PG is spontaneous rapid formation of an extremely painful ulcer on the extremities, associated with significant morbidity and mortality. Rarely, PG can also occur as a chronic peristomal complication or as an acute postoperative complication of a surgical wound. The clinical course is unpredictable; it may not correlate with IBD activity and may even precede a diagnosis of IBD. Pyoderma gangrenosum is a diagnosis of exclusion. Treatment is challenging, often involving a variety of immunosuppressive therapies. This review aims to provide an update for the gastroenterologist on the pathogenesis, presentation, diagnosis, and management of PG, a rare complication of IBD.