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Question category: Dermatology

A 52 year old female has developed a rash on her hands, feet which is gradually spreading centrally, predominantly on the extensor surfaces. She has been unwell for a few days before with a cold and the rash developed suddenly. On examination there is numerous circular lesions approximately 2cm in diameter which have a purpuric or pale centre. She states that new lesions develop whenever if there is any trauma to a site. Which of the following is most commonly associated with the development of these skin lesions?

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