55-Year-Old With Hand Rash

A 55-year-old woman presents to urgent care with complaints of arthralgia and a pustular rash on her hands. She has a past medical history of Crohn disease and has taken infliximab as treatment for the past year. The patient has no recent history of travel or infections and no history of any skin conditions. On dermatological examination, multiple pustules, some becoming confluent to form “lakes of pus,” were seen on the palms and fingers. Bacterial and fungal cultures were negative.

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