Back to Basics: A common rash
12 yo male with no significant pmh presents to the ED with a progressive rash on his feet over the past week. Afebrile and hemodynamically stable. No improvement with topical mupirocin and PO Clindamycin. Derm photos below. Diagnosis? Treatment plan?
Bullae and/or blisters, clear-yellow fluid that turns dark, leaves yellow crust when rupture
-- Staph aureus (MSSA or MRSA) - Epidermolytic toxin A and B act locally to cause blisters
-- Also consider Strep pyogenes (GAS)
Spontaneous resolution in 2-3 weeks OR ...
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