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A 49-year-old male presents to urgent care with 3 days of progressively worsening fever and a widespread painful rash. He also reports dry mouth and painful lesions on his gums. The patient has a history of acute myeloid leukemia, and he received an allogeneic bone marrow transplant 2 weeks prior to onset of symptoms. Physical examination reveals a fever of 101.3°F (38.5°C), several ulcerated lesions on the buccal mucosa, and a violaceous papular rash to the trunk, extremities, palms, and soles. Some lesions follow a follicular distribution and are tender to palpation. Laboratory findings include thrombocytopenia and elevated AST.
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