Review Question - QID 109477

A 32-year-old woman presents to her primary care physician with new-onset, progressively worsening acne over the last 2 weeks. She states that she had acne as a teenager, but it had long since resolved until this episode. She wonders if her acne is due to a new face cream, which she started using several weeks ago. Past medical history is significant for systemic lupus erythematosus (SLE). Last month she was admitted to the hospital for massive hemoptysis, which was found to be a diffuse alveolar hemorrhage due to an SLE flare. During her lengthy hospital stay, she received pulse-dosed intravenous glucocorticoids. She also received vancomycin for a suspected infection. The patient’s history is also notable for 1 year of infertility, for which she is seeing a specialist. She has regular menses every 28 to 30 days. At this visit, the patient’s temperature is 98.4°F (36.9°C), pulse is 70/min, blood pressure is 131/78 mmHg, and respirations are 13/min. Cardiopulmonary and abdominal exams are normal. There are diffuse papules on her face as shown in Figure A. What is the most likely etiology of this patient’s skin condition?