PMC6558859_01
Blisters on patient's upper chest demonstrating positive Nikolsky's sign
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Fig1
Inspection of the patient's skin revealed scattered dusky, flaccid blisters demonstrating positive Nikolsky's sign (Fig. 1).
Lesions distributed over the face and mucosal erosions of the lips
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Fig2
These were distributed over the face (including hairline and scalp), neck, anterior trunk, and back (Fig. 2).
Histological findings from skin biopsy. a Low-power image showing sub-epidermal splitting. b Higher-power image shows splitting with necrotic keratinocytes in the epidermis, accompanied by apoptotic debris
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Fig3
Skin punch biopsy demonstrated sub-epidermal splitting, necrotic keratinocytes in the epidermis, and apoptotic debris (Fig. 3a, b).
Timeline of significant events during patient's hospital course
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Fig4
A timeline of significant events and trend of renal function is outlined in Fig. 4.
CT imaging showing bilateral hydronephrosis and mild hydro-ureters (right); fluoroscopy imaging confirming filling defect (left)
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Fig5
Bedside ultrasound revealed bilaterally enlarged collecting system, and subsequent CT-KUB confirmed bilateral hydronephrosis and mild hydro-ureters with the presence of dependent debris in pelvicalyceal system and ureters (Fig. 5, right). Fluoroscopy confirmed filling defects (Fig. 5, left).
Chest radiograph showing subcutaneous emphysema, pneumothoraces, and pneumomediastinum (left); CT thorax demonstrating pneumomediastinum (right)
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Fig6
Chest X-ray confirmed presence of right-sided pneumothorax, small left-sided pneumothorax, and pneumomediastinum (Fig. 6, left). Pneumomediastinum and contralateral pneumothorax remained stable on several follow-up images throughout the hospital stay, including CT scan for characterisation (Fig. 6, right).