Enlarging vesicular peeling of the palms

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Enlarging vesicular peeling of the palms
Enlarging vesicular peeling of the palms

A 19-year-old African-American man came to the clinic for the evaluation of asymptomatic peeling on his palms. The condition developed after the patient had completed a 10-day course of ciprofloxacin 500 mg b.i.d. The peeling had originated on the tips of his thumbs and fingers and progressed to his palms. The first signs of disease were superficial, pinhead-sized, white macules that progressed to empty vesicles with dry, flaccid, paper-thin roofs. As the lesions enlarged, the central portions would rupture; the edges would become ragged as the roof peeled away. New lesions continued to appear, and there was coalescence of enlarging older lesions.

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