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Itchy Leg Blisters

UNFINISHED CASE: COME BACK LATER 

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History of Present Illness:

A 72-year-old male presents to the ED with worsening rash for four days. ?The rash started in the bilateral lower extremities and he is a few new lesions to his right arm. ?The rash is itchy and burns but not really painful. He has never experienced this before. He has no known allergies. ?He denies lip swelling, tongue swelling, difficulty breathing or other complaints.

Vital Signs & Physical Exam:

Vital signs are normal. Physical exam is normal except for the rash shown below and some mild dependent edema.

Initial Differential Diagnosis:

  • Pemphigoid
  • Pemphicus
  • E. multiforme
  • Allergy

Initial Diagnostic Testing:

  • CBC and BMP are normal except for mild eosinophilia
  • ESR is normal but CRP is elevated

QUESTIONS:

  1. What does the case image show?  (click two times to enlarge)
  2. What should you do next?  
  3. Want a 1-minute consult/tutorial on this case? 
  4. Want to know what happened with this patient?

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ANSWERS:

  1. What does the case image show?  The image shows .
  2. What should you do next?  Treat with.  Consult.
  3. Want a 1-minute consult/tutorial on this case?  See yellow area from sample page below.
  4. Want to know what happened with this patient?  See case conclusion below tutorial page.

1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

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CASE CONCLUSION: We’ll just have to see

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