This 46-year-oldl woman developed generalized erythema, most severe on the proximal extremities and trunk, several hours after receiving parenteral normal saline with iron, amino acids, and cobalamin at a medical clinic. Numerous confluent pustules superimposed on the erythematous edematous confluent plaques followed one day later. Although she was afebrile, leukocytosis(18,000/cubic mm) and elevated CRP were noted. A bacterial culture from the pustules was negative. A skin biopsy showed intracorneal pustules with numerous neutrophils and neutrophilc infiltration of the epidermis and upper dermis.
generalized erythema and edema with superimposed discrete and confluent 2-3 mm pustules