A 62-year-old male with follicular lymphoma presented with a 3-week history of worsening erythematous, coalescing papules and plaques with desquamative scale, and oral mucosa erosions starting 4 days after receiving rituximab, bendamustine, trimethoprim/sulfamethoxazole, and allopurinol (Fig 1, A-C). There was no improvement after holding medications, oral prednisone, and topical steroids. Biopsy of the dorsal hand was performed (Fig 2). Within 2 weeks, the rash progressed to erythroderma with erosions and hemorrhagic crusting of mucosal sites and diffusely on the body (Fig 3, A-C).

A 62-year-old male with follicular lymphoma presented with a 3-week history of worsening erythematous, coalescing papules and plaques with desquamative scale, and oral mucosa erosions starting 4 days after receiving rituximab, bendamustine, trimethoprim/sulfamethoxazole, and allopurinol (Fig 1, A-C). There was no improvement after holding medications, oral prednisone, and topical steroids. Biopsy of the dorsal hand was performed (Fig 2). Within 2 weeks, the rash progressed to erythroderma with erosions and hemorrhagic crusting of mucosal sites and diffusely on the body (Fig 3, A-C).