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May 2005
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History:
18 yo Caucasian female presented to the ER with a day history
of a painful, dusky erythematous rash on her anterior trunk, back,
buttocks, and posterior legs (Figs 1-3). The patient had been
receiving methotrexate 25 mg IM weekly for the past three weeks
for a hydatidiform mole. She denied any recent history of sunburns
or radiaton exposure, though she did report regular tanning bed
use, which was stopped less than one week prior to initiating
methotrexate therapy.
Physical Exam:
Skin examination revealed diffuse areas of dusky erythema
covering ~30% of the body surface area on the chest, back, buttocks,
and posterior legs. Several bullae and multiple fine vesicles
were noted on the buttocks and popliteal fossa. There was no mucosal
or ocular involvement.
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