NEJM CASE- 46 yoM with Arthritis (wrists, ankles) and maculopapular Rash (chest, back, legs); prior travel to Caribbean, C. America, HTN, Tachycardia, ESR 104 , nl CRP, but ^d-dimer 990. Scattered alopecia & nasal crusting. Vote your Dx https://t.co/3bdmbnSdlB https://t.co/0R4WK1SKI2