Problem: A 49-year-old woman with a history of systemic lupus erythematosus was recently discharged after undergoing splenectomy for thrombocytopenia. She has been receiving azathioprine and oral prednisone for the last 9 months. Now she is presenting for the second time with a pruritic rash that started 8 weeks ago and was initially diagnosed as psoriasis. The lesions did not improve with topical corticosteroids and she has crusted, scaly plaques in several areas of her trunk and extremities