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Make the diagnosis.

A 27-year-old female presented with pustules on her upper extremities and bilateral antecubital fossa. She also had superficial desquamation with underlying erythema on her torso. Five days prior to presentation, she underwent rhinoplasty for a deviated nasal septum. She received cefazolin during the surgery. One day post surgery, she developed lesions on her arms that then spread to her chest and back. She was treated in the emergency department with prednisone, famotidine (Pepcid), and diphenhydramine (Benadryl). She returned to the emergency department 4 days later and was treated with vancomycin, piperacillin/tazobactam, and clindamycin for possible toxic shock syndrome. She was admitted to the hospital and dermatology was consulted. Her liver function tests and eosinophil count were normal.

Make the diagnosis:

a) Sneddon-Wilkinson disease

b) Pustular psoriasis

c) Acute generalized exanthematous pustulosis (AGEP)

d) Drug rash with eosinophilia and systemic symptoms (DRESS)


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Publication:Dermatology News
Article Type:Case study
Date:Dec 1, 2016
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