Patient of Dr M Tun

61 yr old man who presented to ED with 5 days h/o this pustular rash over his upper chest/ back and face. It's getting worse and he never had these before. Rashes are neither irchy or painful and he is systematically well.
Background - nil sig h/o.
What he concerned was he took tramadol 10 days before these rash appeared for his Rt knee arthritis.
Thanks for your comment and Dx.

Case Comments     
This is a pustular rash. Therefore the mnemonic is II Infective or Inflammatory (either drug or pustular psoriasis) I would swab this for culture and probably biopsy a lesion. In the abscence of fever it is likely to be a pustular drug eruption rather than an infective process. (Submitted By: Dr Ian McColl)