Middle-Aged Man With Rash

A 55-year-old man with a history of hypertension presented to the emergency department (ED) with complaints of a bilateral lower extremity rash for 1 week (Figures 1 and 2). The patient initially noticed a spotted rash around his sock line, which he attributed to "ringworm." During the course of the next week, the lesions spread proximally and coalesced into a palpable rash. He denied preceding illness or use of any new soap or detergents. On review of systems, he did note a red tint to his urine but denied abdominal or joint pain.

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