A 23-year-old white male presents to dermatologists office with a skin rash affecting his hands and feet. He reports feeling tired and achy over the past week and thought he had the flu. He then noted that his hair was falling out and it looked like he suddenly had a few bald spots. Development of bald spots triggered his visit to the doctor. Other symptoms include headache and low-grade fever. The patient reports no history of previous illness, his past medical history is negative, no medications, and no allergies. Social history is positive for heavy alcohol use on weekends. The patient is unmarried, but in a relationship. On physical examination a papular rash involving the palms and soles is apparent. Lesions are reddish, approximately 4 mm in diameter, and symmetric. Full body examination reveals a pale, almost unnoticeable pink rash on the patient's torse, which the patient claims to not have noticed. Patchy scalp alopecia is noted.