An Unusual Cause Behind Diffuse Itching and Redness

​BY MARISEL ​​VAZQUEZ​; ARIEN KASRA; &AHMED RAZIUDDIN, MDA 70-year-old woman with a history of breast cancer and a lumpectomy and lymph node dissection 20 years before presented to the ED because of redness and itching for two weeks covering the entire surface of her skin. Two weeks before that, she went for a Pap smear and was prescribed fluconazole for Candida vulvovaginitis infection. She took one dose of the fluconazole and an hour later became itchy and red and felt as if her entire body were burning.The itching and redness were diffuse and had persisted for two weeks, neither worsening nor improving. She had no exacerbating factors: The symptoms did not worsen with water, soap, or sunlight. She reported some change in her voice and some loose stools, but reported no shortness of breath, wheezing, constipation, sore throat, dysphagia, fever, history of allergies, chest pain, abdominal pain, nausea, or vomiting. She also had no environmental changes at home. Her past medical history was significant for hypothyroidism, for which she took levothyroxine.An example of exfoliative dermatitis caused by a reaction to phenytoin.The patient's vital signs were a blood pressure of 138/44 mm Hg, a pulse of 99 bpm, a respiratory rate of 18 bpm, a temperature of 99.0°F, and oxygen saturation of 99% on room air. The skin on her entire body was red, with mild exfoliation, but no other physical abnormalities were found.Her initial labs consisted of a CBC wit...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research

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