Maculopapular rash on face, trunk, and extremities
A 45-year-old febrile woman came to the emergency department (ED) with a two-day history of hand and facial swelling (Figure 1) and a three-day history of rash (Figure 2). Laboratory findings included leukocytosis, eosinophilia (29%), and an elevated alkaline phosphatase. The patient’s thyroid-stimulating hormone (TSH) was high, and her thyroxine was low. Four weeks before her trip to the ED, she had started phenytoin for seizures due to neurocysticercosis, but the drug was stopped after three weeks when the rash appeared.