CASE REPORT

A 19 year old man presented with 2 day history of extensive painful pustular eruptions of the hands, forearms, and chest. He also felt unwell and had fever. Fingers were stiff and could not be fully extended. He was seen in the local accident and emergency department and prescribed flucloxicillin. On direct questioning he admitted that his illness started with painful penile ulcers followed 2 days later by generalised crops of blisters, which then …