case_images: PMC6558859_01
case_images: Blisters on patient's upper chest demonstrating positive Nikolsky's sign
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case_images: Fig1
case_images: Inspection of the patient's skin revealed scattered dusky, flaccid blisters demonstrating positive Nikolsky's sign (Fig. 1).
case_images: Lesions distributed over the face and mucosal erosions of the lips
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case_images: Fig2
case_images: These were distributed over the face (including hairline and scalp), neck, anterior trunk, and back (Fig. 2).
case_images: Histological findings from skin biopsy. a Low-power image showing sub-epidermal splitting. b Higher-power image shows splitting with necrotic keratinocytes in the epidermis, accompanied by apoptotic debris
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case_images: Fig3
case_images: Skin punch biopsy demonstrated sub-epidermal splitting, necrotic keratinocytes in the epidermis, and apoptotic debris (Fig. 3a, b).
case_images: Timeline of significant events during patient's hospital course
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case_images: Fig4
case_images: A timeline of significant events and trend of renal function is outlined in Fig. 4.
case_images: CT imaging showing bilateral hydronephrosis and mild hydro-ureters (right); fluoroscopy imaging confirming filling defect (left)
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case_images: Fig5
case_images: Bedside ultrasound revealed bilaterally enlarged collecting system, and subsequent CT-KUB confirmed bilateral hydronephrosis and mild hydro-ureters with the presence of dependent debris in pelvicalyceal system and ureters (Fig. 5, right). Fluoroscopy confirmed filling defects (Fig. 5, left).
case_images: Chest radiograph showing subcutaneous emphysema, pneumothoraces, and pneumomediastinum (left); CT thorax demonstrating pneumomediastinum (right)
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case_images: Fig6
case_images: Chest X-ray confirmed presence of right-sided pneumothorax, small left-sided pneumothorax, and pneumomediastinum (Fig. 6, left). Pneumomediastinum and contralateral pneumothorax remained stable on several follow-up images throughout the hospital stay, including CT scan for characterisation (Fig. 6, right).