What’s the cause for this 55-year-old’s painful rash?

A 55-year-old female from El Salvador presents with this mildly pruritic and painful rash. The rash began on her lower extremities and progressed to cephalad. No systemic symptoms and labs unremarkable, as well as various serologies. Started on 60mg prednisone with minimal improvement and awaiting biopsy results.

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