61yo M with rash starting on foot in summer. Initially respo | Figure 1

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61yo M with rash starting on foot in summer. Initially responded to methylprednisone and PO steroid taper starting at 50mg and doxycycline. Rash recurred with diffuse spread and improved some to repeat PO steroid taper and doxy. ANA panel, TSH, CRP, ESR negative/normal after initial flare. KOH prep negative in office in early fall and repeat positive for hyphae started bleach bath, outpatient. Unable to pick up terbinafine. Returns today with worse rash, fissures, pain. T2DM otherwise no history autoimmune disorders. He is adopted. Suspected Steven Johnson syndrome from azithromycin n 4 years ago.