Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
A 76-YEAR-OLD MAN sought care for a rash that had gotten progressively worse over the previous 3 weeks. He indicated that the rash was initially red, itchy, and located over his abdomen, but as time went by, new blisters developed in the axillae and groin, and they were painful. The patient did not have any arthralgias or systemic symptoms. The medications he was taking included simvastatin, albuterol, and finasteride.
On physical examination, the patient was in mild distress due to the pain and anxiety, and his temperature was 36.5°C (97.7°F). He had confluent areas of erythematous, denuded skin spanning his trunk, back, and proximal upper and lower extremities (FIGURE 1). Tense, fluid-filled blisters were most prominent in the groin and in the axillae, bilaterally.
FIGURE 1
Diffuse rash on the trunk and in the axillae
WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?