Top suggestions for (BMJ) —A woman in her 80s with Parkinson's disease presented with a 4-day history of fever, malaise, sore throat, gritty eyes, and a progressive rash. Six weeks prior, she had started sertraline for low mood, with no known drug allergies or dermatological history. Exam revealed dusky target lesions on acral surfaces, widespread erythematous macules (≥10% BSA), lip and palatal ulceration, and conjunctival hyperaemia. Initial labs showed elevated CRP (156 mg/L), leukocytosis (WCC 12×10°/L, neutrophils 9.7×10°/L), and hyperglycaemia (7.9 mmol/L), with normal LFTs and negative cultures. Within two days, the rash progressed to widespread flaccid blistering and epidermal detachment involving >30% BSA, with a drop in albumin (25 g/L) and CRP rising to 256 mg/L. What's the diagnosis? |
