Abstract

A 48-year-old woman from rural Virginia presented with centrifugally spreading, pruritic, blanchable macules over the lower abdomen and upper thighs noted 4 months after a pancreas transplant. Fever, dyspnea, increasing xerosis, abdominal pain, and constipation were present. The patient had a medical history of type 1 diabetes mellitus requiring a pancreas transplant.

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