A 52-Year-Old Woman Is Brought to the Emergency Department Due

A 52-year-old woman is brought to the emergency department due to a day of fever, lethargy, and skin lesions.  She is currently undergoing combination chemotherapy for diffuse large B-cell lymphoma, and her last treatment was 10 days ago.  Yesterday, the patient developed a red rash on her right thigh.  Within a few hours, a pustule formed in the center of the lesion, rapidly evolved into a dark bulla, and then ruptured and formed an ulcer.  A second, similar skin lesion arose shortly thereafter.  The patient has also had fever and chills and progressive weakness and lethargy.  Temperature is 38.9 C (102 F) , blood pressure is 110/60 mm Hg, and pulse is 106/min.  She has an implanted central venous catheter with a subcutaneous port; the overlying skin is not erythematous or tender.  Cardiopulmonary auscultation reveals clear lung fields and no cardiac murmurs.  The abdomen is soft and nontender.  Skin examination shows a nontender, necrotic ulcer with an erythematous rim and yellow-green, purulent exudate on the right thigh.  There is another lesion with a hemorrhagic dark-bluish bulla and surrounding erythematous, indurated skin.  Leukocyte count is 800/mm³ with 10% neutrophils. Which of the following statements regarding this patient's current condition is most accurate?

A) An associated auto-inflammatory systemic disorder is most likely present.
B) Evaluation by an ophthalmologist is essential to look for endophthalmitis.
C) Extensive and repeated surgical debridements are most likely required.
D) Intravenous antibiotics are most likely to improve this condition.
E) Skin-directed antineoplastic therapy is the treatment of choice.