Retiform Purpura and Coalescent Ulceronecrotic Lesions

Retiform purpura and coalescent ulceronecrotic lesions

A 48-year-old man presented to the emergency department with a 2-week history of fever, shortness of breath, and painful, blistering skin lesions. His temperature was 39.2°C.

Examination revealed retiform purpura and coalescent ulceronecrotic areas over the trunk, arms, and legs. Other findings included the loss of both eyebrows, swelling of the earlobes, the absence of wrinkles on the face, and diffuse alopecia.

What is the diagnosis?