case_images: PMC9393491_01
case_images: (a and b) Facial and truncal blistering, and hemorrhagic oral mucositis at initial presentation (20% BSA involvement).
case_images: 10.1177_2050313X221117887-fig1.jpg
case_images: PMC9393491_01_10.1177_2050313X221117887-fig1.jpg
case_images: fig1-2050313X221117887
case_images: Multiple well-defined tense clear fluid-filled vesicles/bullae (1-10 mm in size) presented on the face, trunk, upper/lower proximal extremities, and labia majora (Figure 1(a) and (b)), affecting 20% of the body surface area (BSA).
case_images: (a-d) Progression of tense cutaneous blisters and hemorrhagic oral mucositis 24 h post-IVIG on day 4 (35% BSA involvement), prior to which she had received methylprednisolone and one dose of ETN.
case_images: 10.1177_2050313X221117887-fig2.jpg
case_images: PMC9393491_01_10.1177_2050313X221117887-fig2.jpg
case_images: fig2-2050313X221117887
case_images: Her mucocutaneous lesions rapidly worsened within 24 h (to 35% BSA involvement post-IVIG (Figure 2(a)-(d)) from 20% pre-IVIG) prompting a second higher dose of ETN (0.8 mg/kg SC) on day 5.
case_images: Resolution of tense blisters, drying of erosions, and halted progression after receiving the second dose of ETN subsequent to IVIG administration given 48 h prior. (a) Facial blistering with erosions and hemorrhagic oral mucositis 24 h after the second dose of ETN on day 6. (b-d) Hemorrhagic oral mucositis and diffuse vesicles and bullae on the trunk with skin sloughing 48 h after the second dose of ETN on day 7.
case_images: 10.1177_2050313X221117887-fig3.jpg
case_images: PMC9393491_01_10.1177_2050313X221117887-fig3.jpg
case_images: fig3-2050313X221117887
case_images: The following day, she demonstrated improvement with drying of erosions and halted progression (Figure 3(a)-(d)).
case_images: Follow-up post-discharge 3 weeks after receiving second dose of ETN. (a and b) There is almost complete resolution of mucocutaneous lesions with only mild desquamation of vermillion lip remains. (c and d) Re-epithelialization has occurred in areas of previous blisters/erosions with minimal dyspigmentation.
case_images: 10.1177_2050313X221117887-fig4.jpg
case_images: PMC9393491_01_10.1177_2050313X221117887-fig4.jpg
case_images: fig4-2050313X221117887
case_images: One-week post-discharge, she had almost complete recovery with minimal dyspigmentation and only mild vermillion lip desquamation remaining (Figure 4(a)-(d)).