Staphylococcal scalded skin syndrome and impetigo Quiz: Ace Your Exams

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A 6-year-old girl presents to the immediate care office with her parent for evaluation of a rash on her right armThe parent states that the rash has been present for the past 1-2 days. The patient has not had any constitutional symptoms, such as fevers or chillsThe patient is otherwise healthy and does not take any daily medicationVaccinations are up-to-date, and the patient has not had any recent sick contacts. The parent has a history of lupus. Temperature is 37°C (98.6°F), blood pressure is 105/71 mm Hg, pulse is 90/min, respiratory rate is 18/min, and oxygen saturation is 98% on room air. The patient is well-appearing and in no acute distress. Skin examination demonstrates vesicles on an erythematous base othe right forearm. Nikolsky sign is negative. There is no mucous membrane involvement. Cardiopulmonary examination is within normal limits. Which of the following tests will confirm the most likely diagnosis? 

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