June 2001
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HISTORY: The patient is a 51 year old Caucasian female with
the sudden development of clusters of pus-filled bumps which coalesce into
large blisters. The lesions were associated with a burning sensation and
occasional itching. Review of systems was negative for fevers, chills, weight
loss, and arthralgias. The patient was on no medications, and past medical
history was significant for adult onset diabetes melitus controlled by diet
and for a total abdominal hysterectomy and bilateral salpingo-oophorectomy.
Physical Exam revealed large confluent erythernatous patches with
overlying crusted pustules covering 80% of the body surface area. In some
areas, the pustules had a serpiginous configuration (Figs. 1-2). The face
and hands were spared. Routine bloodwork, including CBC and chemistries,
were within normal limits.
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