3rd July 2023

A 19-year-old male presents to ED with itchy blisters on his hands. He has just been on holiday to Ibiza with his friends

A 19-year-old male presents to ED with itchy blisters on his hands. He has just been on holiday to Ibiza with his friends. He went on multiple snorkelling trips and touched some coral and is concerned this may have affected his skin. He has a history of hay fever in the summer months for which he was taking cetirizine whilst he was away. On examination, he has tense vesicles on his palms that are extremely itchy. There is no redness or erythema.

Given the likely diagnosis, what is the most likely precipitating factor?

Select the SINGLE most appropriate option from the list below. Select ONE option only.