Case Presentation: A 68-year-old man with hypertension and osteoarthritis presented with fever, cough, dyspnea, and weight loss for 2 months. Prior to admission, he had received antibiotics for community-acquired pneumonia without improvement. Physical exam showed multiple ulcers at the base and sides of tongue, bilateral palmar erythematous papules with ulceration and scaling, bilateral erythematous plaques [...]