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The patient, a 42-eyar-old female, presented with a complaint of red bumps on her lower extremities that were warm and painful to touch. She reported that the lesions appeared 2 days ago, and she was running a fever and feeling tired and generally ill (headache, joint stiffness, and body aches). The patient denied taking any medication except for ibuprofen for symptom relief.

On exam, multiple poorly defined erythematous nodules and plaques were observed in a bilateral distribution on the knees and shins. The patient was febrile (100.1°F [37.8°C]). On questioning, she recalled having an upper respiratory infection 3 weeks prior.

View the image taken (Figure 1) and consider what your diagnosis would be.

Clinical Challenge 2: June, 2012