A 7-year-old girl presented to the emergency department with a 2-week history of fever and with several days of painful blisters on her arms, legs, and face. Two weeks earlier, she had completed a course of penicillin for tonsillitis.
On examination, there were multiple bullae with erythematous bases on the legs and well-demarcated, painful lesions on the lip and soft palate with a shallow round ulcer on her left cheek.
Laboratory studies showed a white-cell count of 32,000 per cubic millimeter (reference range, 5000 to 14,500), with 88% neutrophils.
What’s the diagnosis?
