Backyard Pool Party: Not Your Typical Sunburn

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Two sisters, ages 7 and 10 years, present to their local community emergency department in extreme pain with blistering lesions to their hands, arms, and legs. Earlier in the evening, they noticed some reddened areas to their hands and back of legs after spending the day with 3 other neighborhood friends swimming in a backyard pool and making cool drinks during a hot (103 F) summer day in Central California. After going to bed without distress, the sisters awakened screaming and complaining of burning sensation in all of the affected skin areas (Figs. 1–3). Vital signs, the remainder of the physical examination, and laboratory studies are otherwise unremarkable. Simultaneously, another of the neighborhood friends is at the local burn center. Two additional girls present later the same night for evaluation with similar skin lesions.
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