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A 29-year-old woman presented with fever and worsening chronic painful rash with new pustules on her back. She was previously treated with antibiotics, antifungals, and systemic steroids with minimal improvement. The patient was ill-appearing, febrile, and tachycardic. Skin examination was significant for erythroderma with nonfollicular-based pustules coalescing into annular plaques with ''sunflower-like'' configuration on her back, chest, and legs (Fig 1A/B). Labs were significant for leukocytosis with neutrophilic predominance. Bacterial

We report a case of allergic cheilitis and gingivostomatitis with gastrointestinal (GI) problems whose symptoms resolved after dietary exclusion of the contact allergen.

A 5-year-old girl with a 1-year history of a heart transplant, on immunosuppression with tacrolimus and mycophenolate mofetil and oral valganciclovir for cytomegalovirus prophylaxis, presented with a papular eruption on her face, trunk, and extremities. The lesions were first noted 7 months after her transplant and had spread. There was no associated pain, pruritus, or systemic symptoms such as fever, fatigue, night sweats, or weight loss. On physical examination, numerous hyperpigmented to skin-colored folliculocentric papules with central white keratotic projections were noted on her face, ears, trunk, and extremities, with increased concentration around the patient's nose (Figures 1 and 2). In addition to keratotic spicules, pink to skincolored papules with scale were noted on the patient's lower extremities (Figure 2). A punch biopsy was obtained from a lesion on the lower extremities (Figure 3).