otherwise healthy mid 50's female presents to the ED c/o ski | Figure 1

Patient Case Overview

Case Presentation

A otherwise healthy mid 50's female presents to the ED c/o skin lesions and rash. Afebrile, no mucosal surface involvement. Began three weeks ago with an itchy, red plaque on the dorsum of her left foot. Later developed papules on the plantar aspect which later developed into blistering. Then palms developed the same issue. Saw PCP 3 days ago who consulted with dermatology and prescribed topical triamcinolone, Bactrim and Keflex for likely dyshidrotic eczema. She now has a generalized, extremely pruritic, fine papular rash, worsening of the blisters on her foot and unroofing of the right foot.

Additional Cases

Summary: 43 y.o. F w/Crohns on budesonide x8 weeks had colonoscopy 13 days ago. Developed rash to (L) foot day after surgery. No active ROM of (L) toes, painful passive ROM to 4th & 5th digit. Vascular status intact.

Meds: trazadone, citalopram, budesonide
Allergies: ASA
PmHx: Crohns, depression

Summary: 21 YF with persistent rash/scaly skin to great toe. Reports started as a blister and hasn't improved with aquaphore and frequent foot soaks. Any ideas?

Summary: 23 month old boy presented to family GP with skin lesion rash. Initially started with small flat reddened blister sorts, 3 weeks ago.
No other illness currently.; History of eczema and asthma, no current episodes.

Summary: 16 y/o M received a cut on his leg over a week ago. Blisters started to develop approximately 4 days ago, will pop and drain bloody, yellow fluid and more blisters will appear.

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