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Case Report D.Choe 1/20/16. History 32F with history of depressive symptoms, bipolar disorder, pw itchy and now painful rash for approx 1 week, worsening.

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Presentation on theme: "Case Report D.Choe 1/20/16. History 32F with history of depressive symptoms, bipolar disorder, pw itchy and now painful rash for approx 1 week, worsening."— Presentation transcript:

1 Case Report D.Choe 1/20/16

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3 History 32F with history of depressive symptoms, bipolar disorder, pw itchy and now painful rash for approx 1 week, worsening in past two days Started on Amoxicillin 6 days prior for “strep” Seen at urgent care clinic 4 days prior, discharged with prednisone, pepcid, benadryl Seen here 2d prior for similar complaint, requested discharged after improvement with allergy meds

4 History Reports rash located “everywhere,” accompanied by persistent sore throat, blurry vision Painful upper extremities

5 Physical Symmetrical, generalized papular rash coalesced into macules on the b/l upper extremities with overlying blisters Painful to palpation of upper extremities

6 Physical Symmetrical, generalized papular rash coalesced into macules on the b/l upper extremities with overlying blisters Painful to palpation of upper extremities HEENT: multiple areas of oral lesions <1cm each on inner surface of lips, soft palate; Diffuse conjunctival injection b/l, hesitant to open eyes completely secondary to pain Denies vaginal involvement

7 Physical TBSA of desquamation approx 2-5%

8 Physical TBSA of desquamation approx 2-5% SJS

9 Medications Seroquel Propranolol Prednisone Benadryl Lamotrigene

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14 Causes Allopurinol Aromatic anticonvulsants Antibacterial sulfonamides Lamotrigene Nevirapine Oxicam NSAIDS

15 Predisposing Factors HIV Lupus Malignancies

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