Dermatologic — Macular rash

A 58-year-old man presents to the emergency department with 3 days of fever, painful sores in the mouth and eyes, and a painful rash that began on the trunk 2 days ago and is spreading to the face and limbs. He started a new medication for gout 3 weeks ago after his first acute flare, which he also treated with ibuprofen for 5 days. His only other medication is amlodipine, and he has no known drug allergies. On examination, there are dusky red macules with atypical targetoid centres on the face and trunk, with flaccid blisters and areas of epidermal detachment involving about 8% of body surface area, and the skin sheds when lightly rubbed. There is hemorrhagic crusting of the lips with oral erosions and bilateral conjunctival injection with purulent discharge. Hemoglobin 142 g/L (135-175), WBC 11.2 x10^9/L (4.0-11.0), eosinophils 0.2 x10^9/L (0.0-0.5), creatinine 98 umol/L (60-110), ALT 48 U/L (7-55).