Review Question - QID 214201

A 33-year-old woman presents to the emergency department with a rash, nausea, and vomiting. She states that it has been gradually worsening, and she now feels weak and febrile. She admits to fainting this morning which she thinks may be related. She also believes the rash has been spreading rapidly. The patient has a past medical history of morbid obesity, type II diabetes mellitus, hypertension, and depression, and she does not take her medications regularly. Her menses are currently ongoing, and she has a normal menstrual flow controlled with 2-3 tampons per day. She uses IV drugs intermittently. Her temperature is 102°F (38.9°C), blood pressure is 124/84 mmHg, pulse is 130/min, respirations are 22/min, and oxygen saturation is 98% on room air. Physical exam is notable for the finding in Figure A. Which of the following is the most likely diagnosis?