A 38-year-old lady arrives at an urgent care clinic complaining of a sore throat that has been bothering her for two days. Fever and cervical lymphadenopathy are connected with it, but not rhinorrhea, sneezing, or coughing. On examination, there is erythema and edema affecting the posterior pharynx, as well as a purulent tonsillar effusion. The patient is treated on oral penicillin V after rapid bedside streptococcal antigen testing comes back positive. She returns the next day with a pruritic skin rash that appeared unexpectedly after beginning the medication. The picture below depicts the skin lesions discovered after a physical examination. What is the most likely finding on biopsy of these lesions?

Question

A 38-year-old lady arrives at an urgent care clinic complaining of a sore throat that has been bothering her for two days. Fever and cervical lymphadenopathy are connected with it, but not rhinorrhea, sneezing, or coughing. On examination, there is erythema and edema affecting the posterior pharynx, as well as a purulent tonsillar effusion. The patient is treated on oral penicillin V after rapid bedside streptococcal antigen testing comes back positive. She returns the next day with a pruritic skin rash that appeared unexpectedly after beginning the medication. The picture below depicts the skin lesions discovered after a physical examination.  What is the most likely finding on biopsy of these lesions?

Quizplus · Accepted Answer

Eductional Objective: Urticaria is a temporary hypersensitivity condition characterized by pruritic erythematous plaques that appear rapidly and disappear over a period of hours. They are most commonly produced by IgE-mediated degranulation of mast cells, which results in increased permeability of the microvasculature and superficial dermal edema.

A 38-Year-Old Lady Arrives at an Urgent Care Clinic Complaining