11th August 2020

A 16-year-old girl is accompanied by her mother to the GP with a blistering intensely itchy rash affecting both of her elbows

A 16-year-old girl is accompanied by her mother to the GP with a blistering intensely itchy rash affecting both of her elbows. She says that it started last month since she came back from her trip to Italy. Whilst on her trip she also developed some loose stool but was well otherwise. She had no other symptoms and did not need to present to healthcare services whilst travelling, she does still get the loose stools however. You note that the patient is well systemically, she is afebrile but looks a little dehydrated. You also note a blistering rash on her elbows, some of the blisters have been scratched and you note some crusting and erosions underlying it. You send for stool microscopy, sensitivity and culture, which comes back as unremarkable. A skin biopsy shows sub-epidermal blisters with neutrophil micro-abscesses in the dermal papillae.

For the patient above, please select the SINGLE most likely diagnosis of the dermatological manifestation of their systemic condition/disease. Select ONE option from the list above.