Presenter: Carmen A Julian DO, Irina Milman DO, Eugene Sanik DO

Dermatology Program: PCOM/North Fulton Hospital Medical Campus

CHIEF COMPLAINT: Asymptomatic rash with purplish discoloration on her trunk, extremities and ears

CLINICAL HISTORY: A 40 year old female presenting with fever, cough, hemoptysis and an asymptomatic rash with purplish discoloration on her trunk, extremities and ears. The patient reported the rash started 5 days prior while she was undergoing inpatient treatment for pneumonia at a nearby hospital. The rash started on day two of her admission. She denies pain, bleeding or pruritus associated with the involved areas. She also denied any constitutional symptoms. She received empiric intravenous antibiotics for community-acquired pneumonia on her previous admission. She states that a punch biopsy was performed at her recent outside admission, but our attempts to obtain a report were unsuccessful. No specific treatment for her rash had yet been implemented. The patient left AMA from the previous hospital and presented to our hospital with worsening symptoms. Prior medical records, including the biopsy and antibiotic treatment, again were unavailable. She does admit to tobacco abuse and cocaine abuse, most recently 11 days prior during Independence Day weekend. She denies intravenous drug use.