A 7-year-old female who presented to the clinic with a chief complaint of a rash on her head, arms and legs. The patient has a history of acute lymphoblastic leukemia. She had undergone chemotherapy, went into remission and subsequently received an allogeneic stem cell transplantation from her older brother 20 days ago. The rash started 3 days ago on her ears, palms of her hands and the soles of her feet, progressing further to her arms and legs. It has not progressed to involve her trunk or her extremities and there is no desquamation or bullae formation.
She denies any GI discomfort, crampy abdominal pain or diarrhea. Physical Exam: VS T 38, P 100, R 20, BP 118/65. She is alert and active, in no apparent distress. HEENT negative except for the rash. The rash is an erythematous, maculopapular rash on her palms and soles bilaterally, and on the anterior aspects her arms and…
