A Severe Rash (Questions)
A fifty-one-year-old man with history of treated hypertension and seronegative rheumatoid arthritis presented to hospital with a three day history of a rash affecting the whole body and general malaise. He had been commenced on sulfasalazine 2 weeks ago to control his rheumatoid arthritis, which the patient had discontinued taking three days prior to admission.
On examination, he was comfortable with a temperature of 39oC and a widespread erythematous maculopapular rash. Investigations revealed a normal FBC, UEs, LFTs but high inflammatory markers with a CRP 125.9 and ESR 52.
One day later the patient developed odynophagia and blisters on his lips and mouth shown in the picture below (Figure 1 and 2).
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