Stevens-Johnson syndrome and toxic epidermal necrolysis Quiz: Ace Your Exams
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A 50-year-old woman presents to the emergency department for evaluation of a painful rash that developed one day prior. The patient reports preceding symptoms of fever, malaise, and nausea. The rash began on her chest and face but now also involves the back and both arms, and she has new lesions in her mouth. The patient was started on sulfamethoxazole-trimethoprim two weeks ago for treatment of a urinary tract infection. The patient has a past medical history of HIV and is currently on antiretroviral therapy. Temperature is 38°C (100.4°F), blood pressure is 102/60 mmHg, pulse is 110/min, respiratory rate is 16/min, and oxygen saturation is 97% on room air. On physical examination, there is bilateral conjunctival erythema. There are multiple ulcerative lesions in the oropharynx. Skin exam shows multiple areas of dusky erythema, purpura, target lesions, and flaccid bullae overlying her arms, chest, and back. Once the patient is stabilized, which of the following is the most appropriate disposition?
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