case_images: PMC10894754_01
case_images: Radiographs taken in the emergency department of the patient's left ankle with anteroposterior (A), mortise (B), and lateral views (C) with red arrows indicating soft tissue swelling.
case_images: cureus-0016-00000053011-i01.jpg
case_images: PMC10894754_01_cureus-0016-00000053011-i01.jpg
case_images: FIG1
case_images: An X-ray of his left ankle revealed soft tissue swelling with evidence of his recent ORIF (Figure 1).
case_images: Morbilliform rash on the patient's back that erupted after the administration of cefepime. Circled is the violaceous patch from which a punch biopsy was taken.
case_images: cureus-0016-00000053011-i02.jpg
case_images: PMC10894754_01_cureus-0016-00000053011-i02.jpg
case_images: FIG2
case_images: Over the next few hours, he began to develop mild periorbital edema and a pruritic, erythematous, morbilliform rash on his neck, back, and upper chest (Figure 2).
case_images: Violaceous patches on the patient's forehead, bilateral lower eyelids, left cheek, and lip.
case_images: cureus-0016-00000053011-i03.jpg
case_images: PMC10894754_01_cureus-0016-00000053011-i03.jpg
case_images: FIG3
case_images: His rash continued the next day, and he developed annular violaceous patches with an erythematous rim on his cheeks and forehead, as well as a solitary patch on his left upper back (Figures 3, 4).
case_images: Skin biopsy from the patient's left upper back showed dyskeratotic cells within the epidermis with eosinophils in the epidermis and superficial dermis, along with superficial dermal perivascular lymphohistiocytic inflammatory infiltrate.
case_images: cureus-0016-00000053011-i04.jpg
case_images: PMC10894754_01_cureus-0016-00000053011-i04.jpg
case_images: FIG4
case_images: His rash continued the next day, and he developed annular violaceous patches with an erythematous rim on his cheeks and forehead, as well as a solitary patch on his left upper back (Figures 3, 4). His skin biopsy showed dyskeratotic cells within the epidermis with eosinophils in the epidermis and superficial dermis (Figure 4).