A severe bullous eruption occurring in a patient with chronic active hepatitis and glomerulonephritis

A patient with chronic active hepatitis and membranous glomerulonephritis acquired an acute, fatal illness characterized by a toxic erythematous desquamative dermatitis with bulla formation, fever, diarrhea, and hepatic and renal failure. The cutaneous histopathologic appearance resembled that found in erythema multiforme, toxic epidermal necrolysis, and the acute graft vs host reaction. The cutaneous eruption may have been part of a widespread atuoimmune reaction, possibly triggered by drugs or infection.