Retiform purpura with necrosis and bullae

A 50-year-old woman presents with a 5-day history of progressive, painful rash involving her face, trunk, extremities, nasal tip, and ears, in addition to fever and arthralgia. She admits to a history of polysubstance use and states that her last use was a week prior to symptom onset. She denies a history of autoimmune disease or recent travel. Examination reveals ...