A 5-year-old girl was referred to the pediatric dermatology clinic with a pruritic blistering rash that developed overnight on her face, trunk, and extremities. She was otherwise healthy and had not received any treatment for the rash. There was no family history of skin disease or any known allergies to medications. Four days before rash onset, the child experienced a low-grade febrile illness with vomiting, followed by bilateral red eyes 2 days later. Physical examination revealed several pruritic, tense blisters, some annular with normal central skin, periorally (Fig.1)and bilaterally on her arms and legs (Fig. 2). There were also several erythematous papules on her chest, abdomen, and bilateral buttocks. The remainder of the physical examination was remarkable for bilateral injected conjunctivae and slightly red oral mucosa. A punch biopsy specimen was obtained from a blister on the left thigh for histologic examination (Fig. 3).
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