History of Present Illness: A patient in their mid-70’s with a history of CAN, DM, HTN, presents to the ER with a rash for 2 months starting on his scalp on Dupixent with biopsy 1 week ago confirming eczema. but no new meds and worsening rash since yesterday with chills and shaking.  Peeling a bit for a few days and burning today.

Vital Signs & Physical Exam: Vital signs are normal.  Lungs are clear.  Rash involves palms and soles but not eyes or mouth/throat

Initial Diagnostic Testing:

  • CBC: normal
  • Chem-7: normal
  • Other: ESR = 30 , CRP = 1.5

What is the most likely diagnosis?

  • A) AGEP
  • B) DRESS
  • C) TEN
  • D) Erythroderma

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

 

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QUIZ ANSWER: What is the most likely diagnosis?

  • A) AGEP
  • B) DRESS
  • C) TEN
  • D) Erythroderma – CORRECT: AKA Exfoliative Dermatitis

 

1-Minute Consult on this topic: Click HERE and scroll to page 51.

CASE CONCLUSION: Transferred to tertiary care center with Derm and Burn unit.  Dupixent stopped.  Diagnoses with exfoliative dermatitis and improved on oral steroids and antihistamines plus topical agents.   Missed dermatology follow up appointment because doing so well 😉