A dermatology consult is called to the neurosurgical unit of a children’s hospital for a 16-year-old male patient who developed a rash on his face, chest and lateral upper arms after a surgery.
The patient was admitted to the hospital with headaches and seizures and was subsequently found to have a high-grade anaplastic astrocytoma that invaded the brain stem. A craniotomy was performed with complete resection of the tumor.
Soon after the procedure, the nurse noted the rash. The patient endorses pruritis and has been receiving multiple medications, including vancomycin and piperacillin/tazobactim (Zosyn, Wyeth) prophylactic antibiotics, as well as high-dose dexamethasone for cerebral edema.
Prior to this admission, the patient was healthy with no skin disease or other medical problems.
What could be the Diagnosis ?