title: A severe rash.
abstract: 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 39°C 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).
authors: Royal Bolton Hospital NHS Trust, Bolton, BL4 0JR.
authors: S
authors: S
authors: Bonny
authors: N
authors: N
authors: Jagirdar
authors: S
authors: S
authors: Khan
authors: J
authors: J
authors: Bene