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Make the diagnosis.

A 10-day-old term female neonate is brought in for evaluation of a worsening rash. The mother reports no complications during the pregnancy or birth and says that the patient was previously healthy. The mother first noticed a perioral erythematous eruption 4 days ago, which progressively spread to the neck, trunk, diaper area, and arms. Two days after the onset of erythema, the mother began noticing sloughing of the skin in the patient's neck and axillae. The patient's temperature, taken via rectal thermometer at home, was reported to be 38.8[degrees]C.

Physical exam

On exam, the patient appears well nourished and irritable, with blanching erythroderma. The perioral area is erythematous with radial Assuring and crusting. The skin is denuded with signs of superficial desquamation in the neck fold, axillae, flexural arm surfaces, hands, and in the perineal and perianal areas. Nikolsky sign (when the upper layers of the epidermis easily move laterally with slight pressure or rubbing of diseased skin) is positive. There is no involvement of the oral, nasal, or vaginal mucosa.

What is your diagnosis?

A. Kawaski disease

B. Toxic epidermal necrolysis

C. Epidermolysis bullosa

D. Staphylococcal scalded skin syndrome

E. Candida infection

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Article Details
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Publication:Pediatric News
Article Type:Report
Date:Oct 1, 2015
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