Diffuse Violaceous Macules and Papules on a 42-Year-Old Man

A 42-year-old male without prior significant medical history presented to the emergency department (ED) with a 3-week history of fever, night sweats, sore throat, cough, and rash. Initial laboratory evaluation in the ED revealed a white blood cell (WBC) count of greater than 90,000/uL. The patient was hospitalized for evaluation and treatment of the significant leukocytosis. Dermatology and Hematology-Oncology were consulted for work-up of the rash and leukocytosis, respectively. On physical examination, the patient had numerous discrete violaceous macules and papules scattered on his face, ears, trunk, and extremities.