The patient is a 56-year-old man who emigrated from Mexico to Texas two months ago. He first presented about two weeks ago with a dry cough, chest pain, fevers, and night sweats. Chest x-ray showed a focal consolidation. He had received BCG vaccination as a child, so a PPD was not placed. He was started on isoniazid, rifampin, and ethambutol for tuberculosis.
Now, he presents complaining of the same symptoms, plus a rash that erupted approximately one week ago, after starting the medications about a week prior.
On examination, you find he now has widely distributed dark red plaques that he states are very itchy.
You order another chest x-ray, which looks the same as the previous one. View the images and consider what your next steps would be.