Ulceronecrotic rash in an immunocompetent individual

Abstract

A 28-year-old woman presented with a 6-week history of a pustular rash that began on her ankles and spread upward. Two weeks prior to presentation, she began experiencing eye redness, swelling, and vision loss with enlarged lymph nodes and fatigue. Examination revealed ulcerated papules and plaques involving the face, shins, knees, and thighs (Fig 1). The palms and soles were spared. Postauricular and cervical lymphadenopathy was present, and there was bilateral periorbital edema with conjunctival injection (Fig 2).