Interactive Case Study - March 2021

Question 1:

A 55-year-old woman presents with rash involving the bilateral buttocks, arms, legs and lower abdomen of two days duration. The rash was initially painful and is now pruritic. The patient has a four-year history of acquired short bowel syndrome requiring total parenteral nutrition. Physical examination shows diffuse erythematous plaques with bullae that are slightly raised and tender involving bilateral upper and lower extremities, abdomen and trunk. A 5 mm punch biopsy of involved lateral lower abdomen was obtained and revealed the following histopathology (Figures 1-4).

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Figure 1.


Figure 2.


Figure 3.


Figure 4.

 
What is the best diagnosis?

A.	Acrodermatitis enteropathica

B.	Epidermolysis bullosa

C.	Pemphigus foliaceus

D.	Staphylococcal scalded skin syndrome

E.	Stevens-Johnson syndrome