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February 1993

A Blistering Eruption in an Elderly Woman

Author Affiliations

University of Oklahoma Health Sciences Center, Oklahoma City

Arch Dermatol. 1993;129(2):233-234. doi:10.1001/archderm.1993.01680230119018

REPORT OF A CASE  A 70-year-old black woman was admitted to the urology service with a diagnosis of hemorrhagic cystitis and peritonitis. Twenty-three years before, she had carcinoma of the cervix, which was treated with radiation, and recurrent postirradiation cystitis. During her hospital course, she received four units of packed erythrocytes, and cystoscopy was performed for removal of multiple large blood clots in the bladder. Her peritonitis was treated with intravenous ampicillin and aztreonam for 2 weeks, followed by oral ciprofloxacin. On day 21, pruritus developed over the dorsa of her hands, followed by the appearance of blisters the next day. As the blisters began to spread over the next 2 days, the dermatology service was consulted.Her physical examination revealed numerous 1.0- to 4.0-cm tense bullae, some hemorrhagic, over the dorsa of the hands (Fig 1) and extending to the wrists. In addition, there were numerous bullae on the

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