Four days after delivering a boy by cesarean section, a 24-year-old woman sought care at our gynecology emergency room for a diffuse skin eruption. She said that one day after delivery, she developed several pruritic lesions near the site of the surgical incision. She attributed this to the surgical tape, but within the next 24 hours, blisters began to develop elsewhere on her body.
On exam, we noted light pink papules and plaques—some with overlying tense bullae—in and around her umbilicus (FIGURE 1), as well as on her abdomen, lower extremities, and within the left third and fourth web space of her toes. There were no lesions in the oral mucosa or near the groin or genitalia.
Aside from this blistering skin eruption, our patient was recovering well after the C-section. Her postoperative medications included simethicone, prenatal vitamins with iron, ibuprofen, ferrous sulfate, stool softeners, and acetaminophen with codeine. She indicated that her newborn son didn’t have any health problems—skin or otherwise—and her 2 other sons were healthy. She had no significant medical or dermatologic history. We performed a skin biopsy.