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Acute Severe Blistering in a 24-Year-Old Man—Quiz Case
E. Mary Wain, BSc, MD, MRCP;
Catherine H. Smith, MD, FRCP
University Hospital Lewisham, London, England
Arch Dermatol. 2006;142:1059-1064.
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REPORT OF CASE
A previously healthy 24-year-old man presented to the emergency department with sudden onset of edema and erythema affecting his face, chest, and arms. The symptoms were initially attributed to a type I hypersensitivity reaction to fish curry. He was treated empirically with intravenous hydrocortisone and chlorpheniraminemaleate and was discharged home. Over the subsequent 8 hours, he developed blistering at the sites of the erythema and returned to the emergency department, where he was referred to the dermatology department.
Physical examination revealed an erythematous rash with widespread coalescing vesicles and bullae affecting the chest, upper back area, arms, and right thigh (Figure 1). There was clear demarcation between normal skin and the erythema on the chest and back, with streaky erythema on the chest. The skin creases, especially those around the flexural aspect of the neck, were spared. . . . [Full Text of this Article]
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