This 16 year old girl developed red scaly patches that disseminated over 5 weeks with only rare areas os sparing. Her medical history was complicated by hereditary immunodeficiency, but her growth and development were normal since monthly infusions of intravenous immunoglobulin were started at age 2. The onset of rash was preceded by an episode of sinusitis treated with 10 days of ceftin. While erythrodermic she spiked a fever to 39.5 degrees C. A blood culture and urine culture were positive for Staphylococcus aureus, and she was treated with parenteral vancomycin. Note the small areas of sparing on her ankles, thighs, and forearms.
generalized erythema and scale with rare areas of sparing