Case Presentation A 60-year-old morbidly obese Hispanic woman with a history of hypertension and chronic lymphedema presented to the emergency department with a four-week history of right lower extremity swelling and erythema. Initial Diagnosis & Management Diagnosed with sepsis secondary to non-purulent cellulitis Admitted for intravenous antibiotics and fluids Initial treatment: IV clindamycin and ceftriaxone for 72 hours without clinical improvement Antibiotic regimen switched to ceftaroline for broader coverage Within 48 hours of ceftaroline initiation, the patient developed: Rapidly spreading sterile, non-follicular pustules on an erythematous base, initially on the face and progressing to the torso and upper extremities Pruritus Facial edema Fever of 40 °C Rash sparing lower extremities, palms, and soles (Cover Image A) No mucosal involvement, hemorrhagic crusting Nikolsky’s sign…