Case Presentation A 44 year old African American female with a history of seizure disorder and cirrhosis secondary to alcohol abuse was brought to the emergency department (ED) after a witnessed generalized tonic-clonic seizure on the street. While the patient was in the ED, she was observed to have 500cc of bright red hemetemesis and promptly transferred to the intensive care unit with successful stabilization of an upper GI bleed. It was not until transfer back to the telemetry that she was noted to have a shiny, scaly lesions on her hands and feet bilaterally