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A 28-year-old woman presents with a burning rash on her palms and arms. The rash appeared abruptly two days earlier along with numerous flat, pinkish-red lesions. She now has multiple individual and confluent macular and papular lesions, some with a central vesicle, crusting, or a purplish zone. The only other lesion was a blister on the patient’s lower lip that appeared one day prior to her skin lesions. The blister was being treated with topical docosanol, which the patient had used previously for “cold sore” outbreaks once or twice a year. The patient was afebrile with no systemic symptoms and was taking no medication.
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